An endovascular assisted, nonocclusive cerebral bypass: a technical feasibility study in a rabbit model

J Neurosurg. 2020 Jun 5;134(6):1846-1851. doi: 10.3171/2020.3.JNS20334.

Abstract

Objective: Temporary parent vessel occlusion performed to establish a high-flow interpositional bypass carries the risk of infarcts. The authors investigated the feasibility of a novel technique to establish a high-flow bypass without temporary parent vessel occlusion in order to lower the risk of ischemic complications.

Methods: In 10 New Zealand white rabbits, a carotid artery side-to-end anastomosis was performed under parent artery patency with a novel endovascular balloon device. Intraoperative angiography, postoperative neurological assessments, and postoperative MRI/MRA were performed to evaluate the feasibility and safety of the novel technique.

Results: A patent anastomosis was established in 10 of 10 animals; 3 procedure-related complications occurred. No postoperative focal neurological deficits were observed. The MRI/MRA findings include no infarcts and bypass patency in 50% of the animals.

Conclusions: The authors demonstrated the feasibility of an endovascular assisted, nonocclusive high-flow bypass. Future refinement of the device and technique in an animal model is necessary to lower the complication rate and increase patency rates.

Keywords: New Zealand white rabbit; bypass surgery; cerebral bypass; nonocclusive technique; vascular disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carotid Arteries / diagnostic imaging*
  • Carotid Arteries / surgery*
  • Cerebral Revascularization / methods*
  • Endovascular Procedures / methods*
  • Feasibility Studies
  • Female
  • Imaging, Three-Dimensional / methods
  • Models, Animal*
  • Rabbits