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Skull Base 2005; 15(3): 191-205
DOI: 10.1055/s-2005-872048
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

ELANA: Excimer Laser-Assisted Nonocclusive Anastomosis for Extracranial-to-Intracranial and Intracranial-to-Intracranial Bypass: A Review

David J. Langer1 , 2 , Peter Vajkoczy3
  • 1Department of Neurosurgery, St. Luke's-Roosevelt Hospital Medical Center, New York, New York
  • 2Department of Neurological Surgery, Albert Einstein College of Medicine, New York, New York
  • 3Department of Neurosurgery, Klinikum Mannheim, University of Heidelberg, Mannheim, Germany
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Publication History

Publication Date:
29 July 2005 (online)

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ABSTRACT

ELANA, excimer laser-assisted nonocclusive anastomosis, is a technique using an excimer laser/catheter system for intracranial bypass surgery of the brain. The technique has been developed over the past 12 years by Tulleken and colleagues at UMC Utrecht in The Netherlands for treatment of primarily untreatable giant aneurysms. We review here the emergence of transplanted conduit bypass as a valuable technique for managing these lesions and the subsequent development of ELANA bypass. The ELANA technique allows the operating surgeon to perform an extracranial-to-intracranial or intracranial-to-intracranial bypass using a transplanted large caliber conduit without occlusion of the recipient artery, thus eliminating intraoperative ischemic insult related to temporary occlusion time. We describe the ELANA technique, illustrate it with intraoperative photos, and review the relevant literature. ELANA is shown to be safe; we discuss its advantages over conventional techniques.

KEYWORDS

Excimer laser-assisted nonocclusive bypass - extracranial-to-intracranial bypass - high-flow bypass