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  • van Doormaal, T. P. C.  (3)
  • 2020-2024  (3)
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  • 2020-2024  (3)
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  • 1
    Online-Ressource
    Online-Ressource
    ASME International ; 2020
    In:  Journal of Medical Devices Vol. 14, No. 2 ( 2020-06-01)
    In: Journal of Medical Devices, ASME International, Vol. 14, No. 2 ( 2020-06-01)
    Kurzfassung: A cranial bypass can be a last resort procedure for patients suffering from complex neurovascular pathology. Since the clinically proven excimer laser-assisted nonocclusive anastomosis (ELANA) technique has become available, it is no longer necessary to temporarily close the recipient artery to facilitate an anastomosis. Aiming to simplify and shorten the operation time of the ELANA technique, a sutureless ELANA, the so-called SELANA slide (SEsl) was developed, but it failed during clinical study. We developed an improved device, the SELANA clip (SEcl).We describe the SEcl design and the first in vitro test results. The SEsl design was optimized with a clip at the backside, creating the SEcl which facilitates smooth and friction-free insertion in the recipient artery. Subsequently, the laser catheter was optimized by adding a grid and conus to provide an improved vacuum and flat reaction surface during lasing. We aimed to compare the SEcl to the current ELANA regarding application time difference, anastomosis success (“flap retrieval”) and technical difficulties. Hereto 32 ELANA and 32 SEcl anastomoses were performed on pressurized rabbit arteries in the ELANA practice system. Mean application time difference was 14.0 min (95%CI 13.0–15.0). The flap retrieval rate of the ELANA anastomoses was 94% (30/32) and 100% (32/32) for the SEcl technique. During the experiments no technical difficulties were encountered. The SEcl is technical feasible with promising simplicity and application times. However, extensive in vivo short-term and long-term experiments are indispensable before clinical application.
    Materialart: Online-Ressource
    ISSN: 1932-6181 , 1932-619X
    Sprache: Englisch
    Verlag: ASME International
    Publikationsdatum: 2020
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Springer Science and Business Media LLC ; 2021
    In:  Acta Neurochirurgica Vol. 163, No. 2 ( 2021-02), p. 573-581
    In: Acta Neurochirurgica, Springer Science and Business Media LLC, Vol. 163, No. 2 ( 2021-02), p. 573-581
    Kurzfassung: High flow bypass surgery can be a last resort procedure for patients suffering from complex neurovascular pathology. Temporary occlusion of a recipient artery in these patients could result in debilitating neurological deficits. We developed a sutureless, mechanical anastomotic connection device, the SELANA clip (Sutureless Excimer Laser-Assisted Non-occlusive Anastomosis clip: SEcl). In the present study, we aim to determine the long-term non-inferiority of the SEcl technique compared with historical data of the conventional ELANA anastomosis technique. Methods A total of 18 SEcl bypasses were created on the carotid artery in a porcine model in 6 different survival groups. Mean application times, flap retrieval rates, hemostasis, patency, flow, endothelialization, and remodeling were assessed. Results The mean application time of the SEcl anastomoses was 15.2 ± 9.6 min, which was faster compared with the conventional ELANA anastomoses. The flap retrieval rate of the SEcl anastomoses was 86% (32/37). Direct hemostasis was achieved in 89% (33/37) SEcl anastomoses. Patency in all surviving animals was 94% (17/18). Bypass flow after six months was 156.5 ± 24.7 mL/min. Full endothelialization of the SEcl pins was observed after 3 weeks. Conclusion The SEcl technique is not inferior to the ELANA technique regarding patency, flap retrieval rate, flow, and endothelialization. On the basis of a significantly shorter application time and superior hemostasis, the SEcl technique could be preferable over the ELANA technique. A pilot study in patients is a logical next step based on our current results.
    Materialart: Online-Ressource
    ISSN: 0001-6268 , 0942-0940
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2021
    ZDB Id: 1464215-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    Springer Science and Business Media LLC ; 2020
    In:  Acta Neurochirurgica Vol. 162, No. 1 ( 2020-01), p. 175-179
    In: Acta Neurochirurgica, Springer Science and Business Media LLC, Vol. 162, No. 1 ( 2020-01), p. 175-179
    Materialart: Online-Ressource
    ISSN: 0001-6268 , 0942-0940
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2020
    ZDB Id: 1464215-3
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
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