Endovascular treatment of intracranial ophthalmic segment aneurysms: a series and literature review

Qu, Rong-Bo; Jin, Hua

doi:10.5137/1019-5149.jtn.7710-12.1

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…Each of these risks is avoided in an endovascular approach, such as balloon-assisted coiling (i.e., inflating a balloon at the base of the aneurysm during coiling to secure each coil within the aneurysm's dome), stent-assisted coiling (i.e., deploying a stent at base of the aneurysm to secure the coils within the aneurysm's dome), flow diversion, or flow diversion with adjunctive coiling. While avoiding the challenges of an open approach is what facilitates lower visual morbidity when treating OphAs endovascularly, the recanalization and recurrence rates are higher (21, 24,25,27,[29][30][31]. In a cohort of 138, Lu et al (21) found a 16.1% vs. 2.4% rate of visual deficits after clipping vs. coiling, respectively, while D'Urso et al (31) recognized a 17% rate of recurrence and a 9% rate of re-treatment among a series of 74 carotid-ophthalmic aneurysms treated with coiling alone.…”

Section: Discussionmentioning

confidence: 99%

A novel endovascular treatment for true ophthalmic aneurysms: A case report

Furst

Mattingly²,

Williams³

et al. 2022

Front. Ophthalmol.

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IntroductionCerebral aneurysms located along the internal carotid artery at the origin of the ophthalmic artery can be treated through open surgery or endovascular technique. The former affords more certainty of aneurysm obliteration, while the latter poses less risk to vision. Flow diversion is an increasingly accepted treatment for side-wall carotid aneurysms, although location at the branch point of the ophthalmic artery is known to moderate occlusion outcomes.Case presentationWe present a case of a middle-aged female patient with a morphologically irregular 4-mm ophthalmic artery aneurysm (OphA) and a smaller superior hypophyseal artery (SHA) aneurysm whose successful and uncomplicated obliteration by flow diversion with adjunctive coiling was predicted via a balloon test occlusion (BTO). BTO was employed prior to stent placement to confirm a) ophthalmic artery distal collateralization with external carotid artery (ECA) branches and b) preserved arterial flow in the retina visualized via fundoscopy. At 1 year following angiography, the patient had no postoperative deficits and benefitted from complete occlusion of the OphA and SHA.ConclusionOphAs constitute a complex surgical disease that is historically associated with high visual morbidity. We present a novel advanced endovascular technique of BTO followed by flow diversion with adjunctive coiling that successfully obliterated an OphA while preserving vision.

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