The First Prospective Safety and Effectiveness Trial of the Excimer Laser Assisted Nonocclusive Anastomosis System in Coronary Artery Bypass Grafting

This single-center, single-arm prospective trial provides the first clinical safety and effectiveness data for the excimer laser-assisted non-occlusive anastomosis (ELANA) system in constructing the left internal thoracic artery (LITA)-to-left anterior descending artery (LAD) distal anastomosis during coronary artery bypass grafting (CABG)—a step traditionally hand-sewn and a key barrier to less-invasive bypass techniques. Among 71 patients (89 percent male, mean age 71.0 ± 6.5 years) enrolled between June 2023 and August 2024, device-related major adverse cardiac events (MACE) at one year was 2.9 percent (cardiac death and myocardial infarction (MI) due to LITA failure), with overall MACE of 8.7 percent. Six-month LITA patency by angiography was 92.5 percent (FitzGibbon (FG) A: 40.6 percent, B: 51.6 percent, O: 7.8 percent), and intravascular ultrasound in FG-B patients showed no significant stenosis. The authors conclude that the ELANA device appears safe and effective, though longer follow-up and further trials are needed to confirm durability and to establish whether it can enable genuinely less-invasive CABG approaches.