The authors developed a unique nonocclusive cerebral high-flow bypass approach. This novel approach may be beneficial, particularly for deep bypass surgeries. Infarcts can occur when a temporary parent vascular occlusion is used to provide a high-flow interpositional bypass. The researchers looked into the viability of a new technique for creating a high-flow bypass without using tems. A carotid artery side-to-end anastomosis was accomplished under parent artery patency in 10 New Zealand white rabbits using a new endovascular balloon device. The feasibility and safety of the innovative approach were assessed using intraoperative angiography, postoperative neurological evaluations, and postoperative MRI/MRA.

In ten of ten animals, a patent anastomosis was created, and three procedure-related problems occurred. There were no postoperative focal neurological impairments. In 50 percent of the rats, the MRI/MRA findings revealed no infarcts and bypass patency. The rabbits had a small number of procedures performed, and the lack of histological analysis of the bypass and parent vessel to confirm endothelial integrity. Limitations of the study are as follows: the small number perceived to be too few, and there is no prophylactic regimen to reduce the occurrence of vasospasm and potentially bypass thrombosis.The authors proved the feasibility of a nonocclusive high-flow bypass with endovascular assistance. To reduce complication rates and raise patency rates, further refining of the device and procedure in an animal model is required.

Reference Link – https://thejns.org/view/journals/j-neurosurg/134/6/article-p1846.xml#container-16302-item-16297