Intravascular laser coagulation of experimental aneurysms

Area of Science:

• Neurosurgery
• Vascular Surgery
• Biomedical Engineering

Background:

• Rebleeding after aneurysmal subarachnoid hemorrhage (aSAH) carries a high mortality rate (45%).
• The highest risk for rebleeding occurs within 24 hours of the initial event, with a 20% incidence within two weeks.
• Prompt surgical intervention is crucial but often logistically challenging to implement rapidly.

Purpose of the Study:

• To develop and evaluate an expeditious intravascular laser-catheter technique for treating intracranial aneurysms.
• To assess the feasibility of using laser energy delivered via an optical fiber for aneurysm ablation.
• To determine if the feeding artery remains patent after the procedure.

Main Methods:

• An experimental aneurysm model was created in the rabbit carotid artery.
• A laser-catheter system with an intra-arterial optical fiber was employed.
• The optical fiber tip was positioned within the aneurysm via a catheter inserted through the femoral artery.
• Laser energy (750 mW for 15 seconds) was applied to ablate the aneurysms.

Main Results:

• The intravascular laser-catheter technique successfully occluded 4 experimental aneurysms.
• Aneurysm ablation was achieved while maintaining the patency of the feeding artery.
• Histologic results are pending for this ongoing study.

Conclusions:

• The developed intravascular laser-catheter technique demonstrates potential for rapid and effective treatment of experimental intracranial aneurysms.
• This minimally invasive approach may offer a viable alternative for prompt management of aSAH, addressing the critical need for timely intervention.
• Further long-term histologic evaluation is necessary to fully ascertain the safety and efficacy of this novel technique.