Article
Excimer Laser Assisted Non-occlusive Bypass of Giant Aneurysm of the internal carotid artery
Excimer Laser unterstützter Bypass eines Riesenaneurysma der Arteria Karotis Interna
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Published: | May 4, 2005 |
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Outline
Text
Objective
The ELANA (Excimer Laser Assisted Non-occlusive Anastomosis) technique is a bypass procedure by which the main vessel is not occluded. This allows for a continued bloodstream during the anastomosis. This may imply that this technique has the potential to treat vascular situations where there has previously been no alternative. We report here of the first Swiss case using the ELANA technique in a patient with an Aneurysm of the intracranial internal carotid artery.
Methods
In a 57-year-old patient, a giant aneurysm of the left intracranial internal carotid artery with compression of the left optic tract was detected by MRI, after the patient complained of a right-sided visual field deficit. The angiogram showed the branches of the internal carotid artery arising from within the neck of the aneurysm. As a result neither a clipping or coiling of the aneurysm was an option. An ELANA bypass was performed with a saphenous vein graft from the intracranial internal carotid artery to the trunk of the middle cerebral artery.
Results
The procedure was performed without any perioperative complications. The patient was dismissed home 9 days after the operation without any new neurological deficits. An angiography postoperatively showed a high-flow bypass with reduced filling of the aneurysm as compared with pre-operatively.
Conclusions
We report of our first experience with the ELANA bypass technique in a patient with a giant aneurysm unalienable to coiling or clipping. The lack of temporary occlusion of the involved vessels offers a novel therapeutic option where previously there has been none.