Endovascular treatment of ophthalmic artery aneurysms: Ophthalmic artery patency following flow diversion versus coil embolization

Christopher R. Durst, Robert M. Starke, David Clopton, H. Robert Hixson, Paul J. Schmitt, Jean M. Gingras, Dale Ding, Kenneth Liu, R. Webster Crowley, Mary E. Jensen, Avery J. Evans, John Gaughen

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background and purpose The Pipeline Embolization Device (PED) has been shown to effectively treat complex internal carotid artery aneurysms while maintaining patency of covered side branches. The purpose of this retrospective matched cohort study is to evaluate the effect of flow diversion on the patency of the ophthalmic artery when treating ophthalmic artery aneurysms. Methods A retrospective review of our prospectively collected institutional database identified 19 ophthalmic artery aneurysms treated with a PED. These were matched according to aneurysm diameter in a 1:2 fashion to ophthalmic artery aneurysms treated via coil embolization, although it is important to note that there was a statistically significance difference in the neck diameter between the two groups (p=0.045). Clinical and angiographic outcomes were recorded and analyzed. Results On follow-up angiography, decreased flow through the ophthalmic artery was observed in 26% of the PED cohort and 0% of the coil embolization cohort (p=0.003). No ophthalmologic complications were noted in either cohort. Complete occlusion at 12 months was more common following PED treatment than coil embolization (74% vs 47%; p=0.089), although lower than reported in previous trials. This may be due to inflow into the ophthalmic artery keeping the aneurysm patent. Retreatments were more common following coil embolization than PED (24% vs 11%), but this was not significant (p=0.304). Permanent morbidity rates were not significantly different between the PED (11%) and coil embolization (3%) cohorts (p=0.255). Conclusions Our results suggest that ophthalmic artery aneurysms may be adequately and safely treated with either the PED or coil embolization. However, treatment with the PED carries a higher risk of impeding flow to the ophthalmic artery, although this did not result in clinical sequelae in the current study.

Original languageEnglish (US)
Pages (from-to)919-922
Number of pages4
JournalJournal of NeuroInterventional Surgery
Volume8
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Ophthalmic Artery
Aneurysm
Equipment and Supplies
Therapeutics
Retreatment
Internal Carotid Artery
Angiography
Cohort Studies
Neck
Databases
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Durst, Christopher R. ; Starke, Robert M. ; Clopton, David ; Hixson, H. Robert ; Schmitt, Paul J. ; Gingras, Jean M. ; Ding, Dale ; Liu, Kenneth ; Crowley, R. Webster ; Jensen, Mary E. ; Evans, Avery J. ; Gaughen, John. / Endovascular treatment of ophthalmic artery aneurysms : Ophthalmic artery patency following flow diversion versus coil embolization. In: Journal of NeuroInterventional Surgery. 2016 ; Vol. 8, No. 9. pp. 919-922.
@article{2535cd017537412795c9119771bc9dff,
title = "Endovascular treatment of ophthalmic artery aneurysms: Ophthalmic artery patency following flow diversion versus coil embolization",
abstract = "Background and purpose The Pipeline Embolization Device (PED) has been shown to effectively treat complex internal carotid artery aneurysms while maintaining patency of covered side branches. The purpose of this retrospective matched cohort study is to evaluate the effect of flow diversion on the patency of the ophthalmic artery when treating ophthalmic artery aneurysms. Methods A retrospective review of our prospectively collected institutional database identified 19 ophthalmic artery aneurysms treated with a PED. These were matched according to aneurysm diameter in a 1:2 fashion to ophthalmic artery aneurysms treated via coil embolization, although it is important to note that there was a statistically significance difference in the neck diameter between the two groups (p=0.045). Clinical and angiographic outcomes were recorded and analyzed. Results On follow-up angiography, decreased flow through the ophthalmic artery was observed in 26{\%} of the PED cohort and 0{\%} of the coil embolization cohort (p=0.003). No ophthalmologic complications were noted in either cohort. Complete occlusion at 12 months was more common following PED treatment than coil embolization (74{\%} vs 47{\%}; p=0.089), although lower than reported in previous trials. This may be due to inflow into the ophthalmic artery keeping the aneurysm patent. Retreatments were more common following coil embolization than PED (24{\%} vs 11{\%}), but this was not significant (p=0.304). Permanent morbidity rates were not significantly different between the PED (11{\%}) and coil embolization (3{\%}) cohorts (p=0.255). Conclusions Our results suggest that ophthalmic artery aneurysms may be adequately and safely treated with either the PED or coil embolization. However, treatment with the PED carries a higher risk of impeding flow to the ophthalmic artery, although this did not result in clinical sequelae in the current study.",
author = "Durst, {Christopher R.} and Starke, {Robert M.} and David Clopton and Hixson, {H. Robert} and Schmitt, {Paul J.} and Gingras, {Jean M.} and Dale Ding and Kenneth Liu and Crowley, {R. Webster} and Jensen, {Mary E.} and Evans, {Avery J.} and John Gaughen",
year = "2016",
month = "9",
day = "1",
doi = "10.1136/neurintsurg-2015-011887",
language = "English (US)",
volume = "8",
pages = "919--922",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",
number = "9",

}

Durst, CR, Starke, RM, Clopton, D, Hixson, HR, Schmitt, PJ, Gingras, JM, Ding, D, Liu, K, Crowley, RW, Jensen, ME, Evans, AJ & Gaughen, J 2016, 'Endovascular treatment of ophthalmic artery aneurysms: Ophthalmic artery patency following flow diversion versus coil embolization', Journal of NeuroInterventional Surgery, vol. 8, no. 9, pp. 919-922. https://doi.org/10.1136/neurintsurg-2015-011887

Endovascular treatment of ophthalmic artery aneurysms : Ophthalmic artery patency following flow diversion versus coil embolization. / Durst, Christopher R.; Starke, Robert M.; Clopton, David; Hixson, H. Robert; Schmitt, Paul J.; Gingras, Jean M.; Ding, Dale; Liu, Kenneth; Crowley, R. Webster; Jensen, Mary E.; Evans, Avery J.; Gaughen, John.

In: Journal of NeuroInterventional Surgery, Vol. 8, No. 9, 01.09.2016, p. 919-922.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endovascular treatment of ophthalmic artery aneurysms

T2 - Ophthalmic artery patency following flow diversion versus coil embolization

AU - Durst, Christopher R.

AU - Starke, Robert M.

AU - Clopton, David

AU - Hixson, H. Robert

AU - Schmitt, Paul J.

AU - Gingras, Jean M.

AU - Ding, Dale

AU - Liu, Kenneth

AU - Crowley, R. Webster

AU - Jensen, Mary E.

AU - Evans, Avery J.

AU - Gaughen, John

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background and purpose The Pipeline Embolization Device (PED) has been shown to effectively treat complex internal carotid artery aneurysms while maintaining patency of covered side branches. The purpose of this retrospective matched cohort study is to evaluate the effect of flow diversion on the patency of the ophthalmic artery when treating ophthalmic artery aneurysms. Methods A retrospective review of our prospectively collected institutional database identified 19 ophthalmic artery aneurysms treated with a PED. These were matched according to aneurysm diameter in a 1:2 fashion to ophthalmic artery aneurysms treated via coil embolization, although it is important to note that there was a statistically significance difference in the neck diameter between the two groups (p=0.045). Clinical and angiographic outcomes were recorded and analyzed. Results On follow-up angiography, decreased flow through the ophthalmic artery was observed in 26% of the PED cohort and 0% of the coil embolization cohort (p=0.003). No ophthalmologic complications were noted in either cohort. Complete occlusion at 12 months was more common following PED treatment than coil embolization (74% vs 47%; p=0.089), although lower than reported in previous trials. This may be due to inflow into the ophthalmic artery keeping the aneurysm patent. Retreatments were more common following coil embolization than PED (24% vs 11%), but this was not significant (p=0.304). Permanent morbidity rates were not significantly different between the PED (11%) and coil embolization (3%) cohorts (p=0.255). Conclusions Our results suggest that ophthalmic artery aneurysms may be adequately and safely treated with either the PED or coil embolization. However, treatment with the PED carries a higher risk of impeding flow to the ophthalmic artery, although this did not result in clinical sequelae in the current study.

AB - Background and purpose The Pipeline Embolization Device (PED) has been shown to effectively treat complex internal carotid artery aneurysms while maintaining patency of covered side branches. The purpose of this retrospective matched cohort study is to evaluate the effect of flow diversion on the patency of the ophthalmic artery when treating ophthalmic artery aneurysms. Methods A retrospective review of our prospectively collected institutional database identified 19 ophthalmic artery aneurysms treated with a PED. These were matched according to aneurysm diameter in a 1:2 fashion to ophthalmic artery aneurysms treated via coil embolization, although it is important to note that there was a statistically significance difference in the neck diameter between the two groups (p=0.045). Clinical and angiographic outcomes were recorded and analyzed. Results On follow-up angiography, decreased flow through the ophthalmic artery was observed in 26% of the PED cohort and 0% of the coil embolization cohort (p=0.003). No ophthalmologic complications were noted in either cohort. Complete occlusion at 12 months was more common following PED treatment than coil embolization (74% vs 47%; p=0.089), although lower than reported in previous trials. This may be due to inflow into the ophthalmic artery keeping the aneurysm patent. Retreatments were more common following coil embolization than PED (24% vs 11%), but this was not significant (p=0.304). Permanent morbidity rates were not significantly different between the PED (11%) and coil embolization (3%) cohorts (p=0.255). Conclusions Our results suggest that ophthalmic artery aneurysms may be adequately and safely treated with either the PED or coil embolization. However, treatment with the PED carries a higher risk of impeding flow to the ophthalmic artery, although this did not result in clinical sequelae in the current study.

UR - http://www.scopus.com/inward/record.url?scp=84986000660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84986000660&partnerID=8YFLogxK

U2 - 10.1136/neurintsurg-2015-011887

DO - 10.1136/neurintsurg-2015-011887

M3 - Article

C2 - 26354944

AN - SCOPUS:84986000660

VL - 8

SP - 919

EP - 922

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - 9

ER -