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Monday, March 14, 2011

Bypass surgery on brain artery without halting blood flow

Bypass surgery on brain artery now can be done without halting blood flow.
A surgical device now reduces the risk of stroke and complications during brain bypass surgery a device can maintain blood flow during artery bypass brain surgery.

The United States FDA has now approved a surgical device which makes it possible for a neurosurgeons to redirect the blood flow around the tumor in brain or an aneurysm in patients who are at high risk of getting stroke in standard bypass surgery on brain artery.The name of the surgical kit is ELANA (Excimer Laser Assisted Non-Occlusive Anastamosis) and it is manufactured Elana, Utrecht, Netherlands .This device makes it possible for a neurosurgeons to construct a bypass without shutting down blood flow, creating a bypass is a most critical procedure in any bypass surgery. Surgical Kit ELANA consists of a disposables and implants to carryout laser assisted non occlusive anastamosis it consist of a small platinum ring and a catheter conducting surgical laser light and suction tubing.In an otherwise standard bypass surgery of brain it requires halting blood flow by clipping artery throughout the procedure, therefore the brain bypass surgery would involves greater risk to patients for developing a stroke.
            Now with availability of ELANA surgical Kit it is now possible to create a bypass without shutting down the blood flow this kit now made it possible for a life saving treatment for some of rare conditions where a treatment was not possible due to high risk of stroke and other complications.Therefor US FDA has approved this ELANA surgical Kit on as a Humanitarian Use Device states the press release published by US FDA.
                                            Surgeon first sutures the platinum ring and a section of blood vessel to be replaced on the affected artery , and after that the lesser light and suction catheter slides down the open end of the open end of the blood vessel being replaced till it touches the sutured platinum ring on affected artery , the a circular hole is cut with lesser light on the affected artery and immediately the cut tissue is sucked out of the circulation. Same procedure is repeated on second replacement vessel connecting an artery to be connected, now both the open ends of replacement vessels are sutured together and a bypass is created around the aneurysm or tumor.
                                The adverse events reported with the use of ELNA surgical kit are similar to those occurring with a standard brain bypass surgery, and which are similar to those reported in medical literature, for standard brain bypass surgery.Bypass in brain artery using ELANA kit should not carried out aneurysm or on vessels on the other than large (> 2.5 mm), intracranial arteries if the if the arteries has calcification or arteriosclerosis calcification at the site of surgery, and it should not be used where the affected artery has an abnormality or its wall is thicker than a carotid artery as laser may not cut completely the artery wall and may leave behind a piece of cut artery in such cases increasing the risk of embolism and stroke. Therefore US FDA has asked manufacturer to monitor and postapproval studies about the safety of the device considering cut artery flap retention rate and stroke and mortality.

What is aneurysm?
Aneurysm can be described as a bulging of arteries at a perticular point due to weakening of arterial wall, the arterial wall losses its tone due to wear and tear and because of high blood pressure at that point in artery it forms a balloon like bulge over the weaker portion on artery.
                Aneurism in artery may develop in brain, heart, lower limbs behind the knee and in intestine it is developed in arteries in brain at the circle of Willis or at the base of brain and in heart it is developed in aorta, the artery conveying blood from the left ventricle of the heart which is also called as aortic aneurysm.
                 Aneurysm therefore posse a risk of rupturing the aneurysmal artery may lead to hemorrhage,  it result in stroke if it is present in brain and heart attack in the event of rupture of aneurysm in aorta in heart.
Treatment of aneurism is limited only to surgical intervention and watchful waiting of the symptoms.


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