A cerebral bypass is a surgical technique that involves connecting a blood vessel from outside the brain to a vessel within the brain or from one brain vessel to another. This is done to provide blood to an area of the brain that either needs more blood flow or is fed by a vessel that needs to be sacrificed to treat a specific condition.

Experts at the Center for Endovascular Surgery specialize in conventional techniques of cerebral bypass, as well as a cutting-edge technique called Excimer Laser-Assisted Nonocclusive Anastomosis for Extracranial to Intracranial and Intracranial to Intracranial Bypass or ELANA.

In fact, the Center for Endovascular Surgery is one of only a few sites in the United States to perform the ELANA cerebral bypass. Since the Center's surgeons started performing ELANA in 2006, the Center has taken a leadership role in the emergence of this new cerebral bypass technology in the United States.

ELANA is a technique using an excimer laser/catheter system for cerebral bypass surgery. The technique was developed by a medical team in the Netherlands for treatment of primarily untreatable giant aneurysms. The ELANA technique allows the surgeon to perform an outside-the-brain to inside-the-brain transplant or a transplant of one brain vessel to another brain vessel using special equipment that doesn't block any of the vessels involved. The ELANA approach minimizes the chances of trauma resulting from even a temporary blockage of blood flow during surgery.

Conventional cerebral bypasses come in essentially two types, and both are still used at the Center, depending on the patient's case.

The first type is called an external carotid artery to internal carotid artery bypass or ECA-ICA. The ECA branches normally provide blood to the face and scalp. In fact, you can feel the pulse of the superficial temporal artery (STA) in front of your ear. The STA can safely be surgically disconnected from the scalp and attached to brain vessels. This bypass is used to provide additional flow to a brain when it has lost flow from a large vessel damaged by vascular disease. The ECA-ICA cerebral bypass is performed to decrease the risk of stroke in a small subset of patients.

The second type of cerebral bypass uses a transplanted vessel such as a saphenous vein from the leg or radial artery from the arm to connect an artery in the neck to a large brain vessel. This type of cerebral bypass provides more flow than the ECA-ICA cerebral bypass and is used primarily when a large vessel of the brain needs to be sacrificed in order to cure an untreatable aneurysm or skull base tumor.