Patency, flow, and endothelialization of the sutureless Excimer Laser Assisted Non-occlusive Anastomosis (ELANA) technique in a pig model

Laboratory investigation

Tristan P. C. van Doormaal M.D., Ph.D., Albert van der Zwan M.D., Ph.D., Saskia Redegeld M.Sc., Bon H. Verweij M.D., Ph.D., Cornelis A. F. Tulleken M.D., Ph.D., and Luca Regli M.D., Ph.D.
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  • Department of Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands
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Object

The purpose of this study was to assess flow, patency, and endothelialization of bypasses created with the sutureless Excimer Laser Assisted Non-occlusive Anastomosis (SELANA) technique in a pig model.

Methods

In 38 pigs, a bypass was made on the left common carotid artery (CCA), using the right CCA as a graft, with 2 SELANAs. Bypass flow was measured using single-vessel flowmetry. The pigs were randomly assigned to 1 of 12 survival groups (1, 2, 3, 4, 5, 6, 7, and 10 days; 2 and 3 weeks; and 3 and 6 months). One extra animal underwent the procedure and then was killed after 1 hour of bypass patency to serve as a control. Angiography was performed just before the animals were killed, to assess bypass patency. Scanning electron microscopy and histological studies were used to evaluate the anastomoses after planned death.

Results

The mean SELANA bypass flow was not significantly different from the mean flow in the earlier ELANA (Excimer Laser Assisted Non-occlusive Anastomosis) pig study at opening and follow-up. Overall SELANA bypass patency (87%) was not significantly different from the ELANA patency of 86% in the earlier study. Complete SELANA endothelialization was observed after 2–3 weeks, compared with 2 weeks in the earlier ELANA study.

Conclusions

The SELANA technique is not inferior to the current ELANA technique regarding flow, patency, and endothelialization. A pilot study in patients is a logical next step.

Abbreviations used in this paper: BA = basilar artery; CCA = common carotid artery; ELANA = Excimer Laser Assisted Nonocclusive Anastomosis; ICA = internal carotid artery; MCA = middle cerebral artery; PCA = posterior cerebral artery; SELANA = sutureless ELANA; SEM = scanning electron microscopy.

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Contributor Notes

Address correspondence to: T. P. C. van Doormaal, M.D., Ph.D., Department of Neurosurgery, Rudolf Magnus Institute of Neuroscience, G.03.124, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. email: T.P.C.vandoormaal@umcutrecht.nl.

Please include this information when citing this paper: published online July 22, 2011; DOI: 10.3171/2011.6.JNS101491.

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