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

J Neurosurg. 2011 Dec;115(6):1221-30. doi: 10.3171/2011.6.JNS101491. Epub 2011 Jul 22.

Abstract

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.

MeSH terms

  • Anastomosis, Surgical / instrumentation
  • Anastomosis, Surgical / methods
  • Animals
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / surgery*
  • Catheterization / methods
  • Cerebral Angiography
  • Cerebrovascular Circulation / physiology
  • Endothelium, Vascular / physiology
  • Endothelium, Vascular / ultrastructure
  • Female
  • Lasers, Excimer*
  • Microscopy, Electron, Scanning
  • Models, Animal
  • Sus scrofa
  • Vascular Grafting / instrumentation*
  • Vascular Grafting / methods*
  • Vascular Patency / physiology*