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Visual Outcomes with Flow-Diverter Stents Covering the Ophthalmic Artery for Treatment of Internal Carotid Artery Aneurysms
- Source :
- American Journal of Neuroradiology, American Journal of Neuroradiology, American Society of Neuroradiology, 2015, 36 (2), pp.330-336. ⟨10.3174/ajnr.A4129⟩, AJNR Am J Neuroradiol
- Publication Year :
- 2014
- Publisher :
- American Society of Neuroradiology (ASNR), 2014.
-
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.
- 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
Subjects
Details
- ISSN :
- 1936959X and 01956108
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- American Journal of Neuroradiology
- Accession number :
- edsair.doi.dedup.....5ac8e6e56e62d79b95b53b5369f7390a