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High Flow Extra-Intracranial Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) Bypass for Symptomatic Carotid Artery Occlusion.
MedLine Citation:
PMID:  21389885     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: A high flow bypass is theoretically more effective than a conventional low flow bypass in preventing strokes in patients with symptomatic carotid artery occlusion (CAO) and a compromised hemodynamic state of the brain. OBJECTIVE:: To study the results of Excimer Laser Assisted Non-occlusive Anastomosis (ELANA) high flow extra-intracranial (EC-IC) bypass surgery in these patients. METHODS:: Between August 1998 and May 2008, 24 patients underwent ELANA EC-IC bypass surgery because of transient ischemic attacks (TIAs) or minor ischemic stroke associated with CAO. We retrospectively collected information. Follow-up data were updated by structured telephone interviews between May and September 2008. RESULTS:: In all patients the ELANA EC-IC bypass was patent at the end of surgery with a mean flow of 106 (± 41) mL/min. Within 30 days after the operation, 22 patients (92%) had no major complications while two patients (8%) suffered from a fatal intracerebral hemorrhage. During follow-up of a mean 4.4 (± 2.4) years the bypass remained patent in 18 of the 22 surviving patients (82%) with a mean flow of 141 (± 59) mL/min. All patients with a patent bypass remained free of TIAs and ischemic stroke. In 4 patients the bypass occluded, accompanied by ipsilateral TIAs in 2 patients, ipsilateral ischemic stroke in 1 patient, and contralateral ischemic stroke in another patient. CONCLUSION:: ELANA EC-IC bypass surgery in patients with CAO is technically feasible and results in cessation of ongoing TIAs and minor ischemic strokes, but carries a risk of post-operative hemorrhage.
Authors:
Tristan P C van Doormaal; Catharine J M Klijn; Perry T C van Doormaal; L Jaap Kappelle; Luca Regli; Cornelius A F Tulleken; Albert van der Zwan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-08
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Rudolf Magnus Institute of Neuroscience, 1Department of Neurosurgery, 2Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
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