Ischemic Complications Of Pipeline Stent For Unruptured Ocular Internal Carotid Artery Aneurysms

Objective:To investigate the acute ischemic complications after Pipeline stent implantation for unruptured ophthalmic aneurysm of internal carotid artery and the safety and efficacy of Pipeline stent therapy,and to analyze the risk factors for postoperative acute ischemic complications.Methods:The demographic and clinical data of 440 patients with unruptured aneurysms of the ophthalmic segment of the internal carotid artery who underwent Pipeline stent implantation from November 2014 to October 2019 at 14 clinical centers in the PLUS study were retrospectively analyzed.Modified Rankin Scale score(m RS)was used to assess clinical prognosis,X~2 test was used for univariate categorical variables,and multivariate logistic regression analysis was used to determine which factors were independently associated with acute ischemic complications.Results:Of 440 patients with ophthalmic segmental aneurysms of the internal carotid artery,27(6.1%)developed acute ischemic complications within 30 days after surgery,of which 1.14%were vision-related complications.At the last follow-up,m RS scores of14 patients were 0,5 patients 1,3 patients 2,1 patient 5,1 patient 6,and 3 patients were lost to follow-up.Univariate analysis showed that a history of hypertension(P=0.021)and PED combined with spring coil(P=0.016)for aneurysm treatment were associated with a higher risk of acute ischemic stroke.In the multivariate analysis,the only variable independently associated with acute ischemic stroke was treatment with stents combined with coils(OR,2.514;95%CI,1.027 to 6.152;P=0.044).Conclusions:The cure rate of intraocular aneurysms of internal carotid artery is high,and the incidence of postoperative ischemic complications is low.Most of them have a good prognosis,but a small number of ischemic complications will still bring serious sequelae.PED combined with spring coil for internal carotid artery aneurysms was the only independent variable associated with acute ischemic stroke after surgery.