An intravascular stabilization method of the Excimer Laser Assisted Non-occlusive Anastomosis (ELANA) technique

An intravascular stabilization method of the Excimer Laser Assisted Non-occlusive Anastomosis (ELANA) technique

Posthoorn, A.P.J.

Dankelman, J. (mentor)

Mechanical, Maritime and Materials Engineering

Biomedical Engineering

2017-04-26

The Excimer Laser Assisted Non-Occlusive Anastomoses (ELANA) technique is used to create anastomoses between major arteries in the brain while avoiding the dangerous temporary occlusion of the cerebral blood ow. This decreases the risk of complica ons due to hypoxia of the brain, but the surgery is long and requires a highly skilled vascular neurosurgeon. A er over 500 ELANA surgeries at University Medical Center Utrecht (UMCU) the current clinical success rate is approximately 80%. Non-successful surgery can lead to severe complica ons or even death. Therefore, it is crucial to op mize the technique. In our research we aimed to improve the design of the ELANA toolkit in order to increase the laboratory success percentage, which was 88% in previous studies. Problem analysis revealed that the main cause for failure of the procedure is improper contact of the catheter with the recieving artery during lasering. We researched alterna ve designs which included di erent cu ng techniques, adding posi onal feedback and fool proo ng the setup to reduce the dependency on the skillset of the surgeon. The addi on of a balloon to the catheter which holds the donor vessel results in increased stability and makes ELANA less dependable on the opera ng surgeon. The success rate in a pilot study with the new design on 20 rabbit arteries and 20 human great saphenous vein (GSV) vessels was 100%. This is a promising result, especially as all tests were carried out by non-medical personnel. Further tes ng is recommended to validate these ndings and prove superiority and safety.

Neurosurgery
Vascular surgery
Arterial bypass
Design
Balloon
Device
Stabilization

http://resolver.tudelft.nl/uuid:dc00d2cc-8a23-455d-b4dd-b9c24afc18e8

Student theses

master thesis

(c) 2017 Posthoorn, A.P.J.