Clinical analysis of effects of different surgical forms on internal carotid artery ophthalmic segment aneurysms
CAO Jia-yu
DING Sheng-hao
ZHAO Bing
FAN Yi-ling
PAN Yao-hua
WAN Jie-qing
Abstract：Objective To investigate the clinical effects of different operative forms on ophthalmic segment aneurysms (OSAs). Methods The clinical data of 88 patients with 109 OSAs including with 57 unruptured OSAs and 31 with ruptured OSAs, who were treated in Renji Hospital from August, 2005 to December, 2015, were analyzed respectively. Of 88 patients with 109 OSAs, 77 with 98 OSAs were treated by endovascular embolization, and 11 with 11 OSAs by microsurgical clipping. All the patients were followed up with MRA or CTA or DSA and received the assessment of prognosis with modified Rankin scale (mRS) 3, 6 and 12 months after the operation. The improvements of ophthalmic symptoms were followed up 3, 6 and 12 after the operations in the patients with visual deficit caused by OSAs. Results Of 69 small OSAs in 65 patients without ophthalmic symptoms, 49 received stent-assisted coiling embolization and 20 only by coiling embolization. OSAs recurred in 2 (3.1%) aneurysms during the following-up. Of 17 large or giant OSAs in 17 of these 65 patients without ophthalmic symptoms, 2 were treated by balloon-assisted coiling embolization, 13 by stent-assisted coiling embolization, and 2 by balloon combined with stent-assisted coiling embolization. OSAs recurred in 5 (29.4% , 5/17) during the following-up. Of 23 patients with visual deficit caused by OSAs including 12 patients with small OSAs and 11 patients with large or giant OSAs, 12 were treated by interventional embolization, and 11 by microsurgical clipping of OSAs. The following-up after the operation showed that the ophthalmic symptoms were improved in 6, unchanged in 3 and worsen in 3 of 12 patients with visual deficit undergoing the interventional embolization. The ophthalmic symptoms were improved in 7, unchanged in 3 and worsen in 1 of 11 patients with visual deficit undergoing the microsurgical clipping during the following up. Conclusions The endovascular embolization is a minimally-invasive, safe, and effective method to treat OSAs, but the microsurgical clipping is superior in the improvement of visual deficit to interventional embolization in the patients with OSAs.
Keywords：Intracranial aneurysmInternal carotid arteryOphthalmic segmentEndovascular treatmentMicrosurgery
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 19-21,28 )