Laser-assisted bypass of the internal carotid artery prior to treatment ofan 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 maj or source of arterial supply to the tumor. Therefore, surgery had to be don e in two stages, The first stage started with an extracranial-intracranial bypass by means of the excimer laser-assisted procedure. This technique pre cludes temporary cross-clamping of intracranial arteries. This by-pass proc edure was followed by occlusion of the internal carotid artery. Then, in th e second stage, the tumor was safely removed.