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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Excimer laser assisted non-occlusive anastomosis (ELANA) as an emergency option for acute ruptured complex ICA aneurysms

Meeting Abstract

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  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Jan-Karl Burkhardt - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Guiseppe Esposito - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Luca Regli - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 159

doi: 10.3205/14dgnc553, urn:nbn:de:0183-14dgnc5536

Published: May 13, 2014

© 2014 Bozinov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Complex ICA aneurysms including giant aneurysms are difficult to treat, especially in an acute setting as presented with subarachnoid hemorrhage (SAH).

Method: Analysis of patients operated with an excimer laser assisted non-occlusive anastomosis (ELANA) as an emergency treatment for acute ruptured complex ICA aneurysms between 6/2013 and 11/2013.

Results: Out of 4 patients operated in this consecutive six-month period, 2 patients received emergency ELANA bypass for ICA aneurysms, both presented with subarachnoid hemorrhage and newly diagnosed giant aneurysms. Both patients received a high-flow EC-IC Bypass with interposition of a saphenous vein graft between the external carotid and the terminal carotid artery. The intracranial anastomosis was performed by the use of the ELANA technique: no occlusion of the recipient artery was needed, because of the non-occlusive nature of this technique. The aneurysms have been successfully treated by trapping of the ICA. There was no mortality, postoperative hemorrhage or major persistent morbidity in both patients.

Conclusions: Emergency ELANA bypass surgery is a surgical option in acute ruptured complex aneurysms if other treatment options (endovascular or surgical clipping) are not possible.