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Toronto Western's Michael Tymianski uses a laser system to perform bypass surgery in the brain, a procedure that doesn't require cutting off the blood supply to the artery that is being repaired and dramatically lessens the risk of a stroke during surgery. He uses it to treat complicated brain tumours and aneurysms, a bulge or ballooning in the wall of an artery. It can involve one artery, as shown below, or two.

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The main artery is not blocked with clamps. A piece of a vein, usually taken from the leg, is sewn on to the outer wall of artery on the left side of the aneurysm. A second piece is attached to the right. The artery is not punctured.

TEXT: ANNE McILROY, GRAPHIC: TRISH McALASTER SOURCE: ELANA.COM

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A fiberoptic cable attached to the laser is slid into the vein and cuts a round hole in the wall of the artery. The laser is a large machine that sits next to the patient, but the light and energy are transmitted through the cable.

TEXT: ANNE McILROY, GRAPHIC: TRISH McALASTER SOURCE: ELANA.COM

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The cable is retracted and the vein is clamped off to stop the blood flow from the artery. Vacuum suction keeps the circular tissue cut attached to the tip of the cable. The laser cuts a second hole in the artery where the vein on the right has been attached. It is clamped off as well.

TEXT: ANNE McILROY, GRAPHIC: TRISH McALASTER SOURCE: ELANA.COM

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The two veins are sutured together to provide an alternative route for blood to circulate through the brain and avoid the aneurysm.

TEXT: ANNE McILROY, GRAPHIC: TRISH McALASTER SOURCE: ELANA.COM

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The clamps are removed from the veins, and the blood flows through. The aneurysm can now be taken out of circulation.

TEXT: ANNE McILROY, GRAPHIC: TRISH McALASTER/THE GLOBE AND MAIL SOURCE: ELANA.COM

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