title: Clinical and imaging follow-up after surgical or endovascular treatment in patients with unruptured carotid-ophthalmic aneurysm.
abstract: BACKGROUND
  Carotido-ophthalmic aneurysms are complex and their treatment is challenging. Few data are available on patient follow-up after endovascular or surgical treatment.
  
  
  OBJECTIVE
  To evaluate outcome of patients with unruptured carotido-ophthalmic aneurysm after endovascular or surgical treatment.
  
  
  METHODS
  This series included 52 consecutive patients in a single center treated for an unruptured carotido-ophthalmic aneurysm at Lille University Hospital between 2000 and 2011. Visual disturbances were present in 5 patients. Treatment option (endovascular or microsurgical) was decided for each patient in a multidisciplinary meeting. We recorded age and the American Society of Anesthesiology score (ASA) before treatment and the modified Rankin Scale score (mRS) at 3 months after treatment. All patients had conventional angiography performed before and immediately after treatment. Long-term imaging follow-up was performed at 3 years after treatment.
  
  
  RESULTS
  Treatment was endovascular in 29 patients and microsurgical in 23. The mean follow-up was 4.6 years. Conventional angiograms showed multiple intracranial aneurysms in 26 patients. Age, pre-therapeutic ASA score and mRS score at 3 months after treatment showed no significant difference between microsurgery and endovascular treatment. Imaging follow-up showed aneurysm recurrence after endovascular treatment in 6 patients including 3 with major recurrence that required further treatment by microsurgery. In these 3 major recurrences, the initial conventional angiography demonstrated the origin of the ophthalmic artery at the neck or from the aneurysmal sac in 3 cases. After microsurgery, conventional angiography showed a remnant neck in 2 patients including 1 treated by further endovascular procedure.
  
  
  CONCLUSIONS
  Endovascular treatment remains the first therapeutic option when the ophthamic artery originates at a distance from the neck, but microsurgery should be considered for large aneurysms with optic nerve compression, or when the ophthalmic artery arises from the neck of the aneurysm.
authors.affiliation: Department of Neurosurgery, Lille University Hospital, Lille cedex, France. Electronic address: rabihdoc@hotmail.com.
authors.forename: Rabih
authors.initials: R
authors.lastname: Aboukaïs
authors.affiliation: Department of Neurosurgery, Lille University Hospital, Lille cedex, France.
authors.forename: Fahed
authors.initials: F
authors.lastname: Zairi
authors.affiliation: Department of Neurosurgery, Lille University Hospital, Lille cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bourgeois
authors.affiliation: Department of Neurosurgery, Lille University Hospital, Lille cedex, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Thines
authors.affiliation: Department of Neuroradiology, Lille University Hospital, Lille cedex, France.
authors.forename: Erwah
authors.initials: E
authors.lastname: Kalsoum
authors.affiliation: Department of Neuroradiology, Lille University Hospital, Lille cedex, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Leclerc
authors.affiliation: Department of Neurosurgery, Lille University Hospital, Lille cedex, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Lejeune
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Aneurysm; Carotid–ophthalmic; Clipping; Endovascular treatment