Rebleeding after aneurysmal subarachnoid hemorrhage has a 45 per cent mortality rate. The peak incidence is within 24 hours of the initial bleed. During the ensuing 2 weeks 20 per cent of patients with suffer a second hemorrhage. To avoid this, surgical treatment must be instituted promptly but, logistically, this is often difficult to implement. To this end, we have devised an intravascular laser-catheter technique that may provide expeditious treatment for intracranial aneurysms. We have coagulated experimental aneurysms in the rabbit carotid artery using laser energy transmitted through an intra-arterial optical fiber. The special fiber tip was positioned in the aneurysm by a catheter introduced from the femoral artery. Laser power of 750 mW and an exposure of 15 seconds caused aneurysm ablation leaving the feeding artery patent. To date, 4 experimental aneurysms have been occluded by this technique and long term histologic results are pending in this ongoing study.
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