1. Visual Outcomes with Flow-Diverter Stents Covering the Ophthalmic Artery for Treatment of Internal Carotid Artery Aneurysms
- Author
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O Leclerc, Y. Benayoun, M.-P. Boncoeur, Francesco D'Argento, Aymeric Rouchaud, P.-Y. Robert, S. Saleme, Charbel Mounayer, Y. Camilleri, Service d'Ophtalmologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), and Service de Radiologie et Imagerie Médicale [CHU Limoges]
- Subjects
Carotid Artery Diseases ,Male ,MESH: Ophthalmic Artery ,medicine.medical_treatment ,Ophthalmic Artery ,Prospective Studies ,Prospective cohort study ,MESH: Treatment Outcome ,Flow diverter ,MESH: Aged ,MESH: Middle Aged ,Interventional ,Endovascular Procedures ,digestive, oral, and skin physiology ,Middle Aged ,3. Good health ,Treatment Outcome ,cardiovascular system ,Optic nerve ,Female ,Stents ,Radiology ,Internal carotid artery ,Carotid Artery, Internal ,Adult ,medicine.medical_specialty ,MESH: Carotid Artery, Internal ,MESH: Endovascular Procedures ,education ,MESH: Intracranial Aneurysm ,Aneurysm ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Endovascular treatment ,Aged ,MESH: Humans ,MESH: Carotid Artery Diseases ,business.industry ,Stent ,Intracranial Aneurysm ,MESH: Adult ,equipment and supplies ,medicine.disease ,MESH: Prospective Studies ,MESH: Male ,Surgery ,MESH: Stents ,Ophthalmic artery ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Neurology (clinical) ,business ,MESH: Female - Abstract
BACKGROUND AND PURPOSE: Flow-diverting stents can be used to treat intracranial aneurysms that are not amenable to treatment with coils. We analyzed ophthalmic consequences due to coverage of the origin of the ophthalmic artery by flow-diverting stents for the treatment of internal carotid artery aneurysms. MATERIALS AND METHODS: From April 2009 to April 2013, the clinical and angiographic outcomes of all 28 patients treated for aneurysms with flow-diverting stents covering the origin of the ophthalmic artery were prospectively collected. The origin of the ophthalmic artery in relation to the target aneurysm was classified by using a 4-type classification. A complete ophthalmic examination was performed by a single ophthalmologist 48 hours before and 1 week after covering the ophthalmic artery. RESULTS: Ophthalmic artery patency was normal at the end of endovascular treatment in 24/28 cases (85.7%). With extensive ophthalmic examinations, 11 patients (39.3%) showed new ophthalmic complications. Patients with the ophthalmic artery originating from the aneurysm sac were at high risk for retinal emboli (4/5, 80%). Patients with the ophthalmic artery originating from the inner curve of the carotid siphon were at high risk for optic nerve ischemic atrophy (3/4, 75%). CONCLUSIONS: This prospective study shows that covering the ophthalmic artery with a flow-diverting stent is not without potential complications. Ophthalmic complications can occur but are often not diagnosed. The anatomic disposition of the ophthalmic artery in relation to the carotid siphon and aneurysm should be clearly understood because some configurations have a higher risk. When not required, covering of the ophthalmic artery by flow-diverting stents should be avoided.
- Published
- 2014