Endovascular Treatment Of Ophthalmic Artery Aneurysm

Objective To investigate the methods of endovascular treatment of ophthalmic artery aneurysms.Methods The clinical data, manifestation and endovascular treatment of12patients with ophthalmic artery aneurysms were reviewed retrospectively.2patients were embolized simplely by coiling,1patient embolized with double microcatheter,6by stent-assisted coil embolization and3patients were treated by remodeling techniques using ballon and coil embolization. Stent-assistive technology firstly choosed the right Solitaire AB stents,then partly released across the neck,and put the the micro-catheter carefully into the aneurysm cavity and set off GDC until embolization was satisfied, and then released stents completely, be sure that length of the stents were5mm longer near and far from the neck of aneurysm; The balloon-assistive technology, is firstly to put the micro-catheter carefully into the aneurysm cavity, and balloon was set to aneurysm neck, filling to cover the neck, then released GDC to fill the aneurysm; Double catheter technique is that two kinds of appropriate micro-catheter are put into the aneurysm cavity,and go through one micro-catheter to set off a appropriate GDC, temporary not to disentangle, then through another micro-catheter in turn released the GDC until satisfaction, finally disentangled the first GDC.Results Among patients accounting for10%of the patients with intracranial aneurysms in the same period, the male2cases, female10cases; Age:25～70years old, an average of49.6years. In5patients with high blood pressure, and1case combined with chronic bronchitis. Clinical symptoms:headache associated with nausea,Visual impairment in1; Visual field defects in1; Physical activity obstacles in2cases; After a sudden coma in2cases; Body twitching in2cases.11cases of performance for SAH, H-H classification:I-II grade8cases, III grade3cases. All patients were one-time embolized and the Glasgow Outcome Scale of good recovery was obstained in all. No recuurence was observed during the follow-up peried ranged from5-17months with a mean of10.1months.Conclusions (1) The ophthalmic artery aneurysm are common among older women,and clinical symptoms are related to their position and weather aneurysm is broken or not, without obvious specificity.(2) Imaging examination is preoperative to the diagnosis and plays the important role on the determination of the effective treatment, particularly CT and DSA, which can be used to find whether the aneurysms burst or not and determine its shape, size, length of the aneurysm neck.(3) The ophthalmic artery aneurysms are in deep position,and the neck is mostly very wide. Endovascular treatment is the first choice for most patients with ophthalmic artery aneurysms. Because of its property of wide neck, stent or ballon-assisted coiling is one of the appropriate methods owing to its extreme advantage, i.e. intact patency of the parent artery, as well as the feasibility, safety, validity, and minimal invasion.