Laser-assisted bypass of the internal carotid artery prior to treatment of an extensive angiofibroma.

A 23-year-old man presented with an extensive nasopharyngeal angiofibroma. The inferolateral trunk, a branch of the internal carotid artery, was a major source of arterial supply to the tumor. Therefore, surgery had to be done in two stages. The first stage started with an extracranial-intracranial bypass by means of the excimer laser-assisted procedure. This technique precludes temporary cross-clamping of intracranial arteries. This bypass procedure was followed by occlusion of the internal carotid artery. Then, in the second stage, the tumor was safely removed.