title: Visual outcomes with flow-diverter stents covering the ophthalmic artery for treatment of internal carotid artery aneurysms.
abstract: OBJECTIVE
  Flow-diverting stents can be used to treat intracranial aneurysms that are not amenable to treatment with coils. We analyzed ophthalmic consequences due to coverage of the origin of the ophthalmic artery by flow-diverting stents for the treatment of internal carotid artery aneurysms.
  
  
  METHODS
  From April 2009 to April 2013, the clinical and angiographic outcomes of all 28 patients treated for aneurysms with flow-diverting stents covering the origin of the ophthalmic artery were prospectively collected. The origin of the ophthalmic artery in relation to the target aneurysm was classified by using a 4-type classification. A complete ophthalmic examination was performed by a single ophthalmologist 48 hours before and 1 week after covering the ophthalmic artery.
  
  
  RESULTS
  Ophthalmic artery patency was normal at the end of endovascular treatment in 24/28 cases (85.7%). With extensive ophthalmic examinations, 11 patients (39.3%) showed new ophthalmic complications. Patients with the ophthalmic artery originating from the aneurysm sac were at high risk for retinal emboli (4/5, 80%). Patients with the ophthalmic artery originating from the inner curve of the carotid siphon were at high risk for optic nerve ischemic atrophy (3/4, 75%).
  
  
  CONCLUSIONS
  This prospective study shows that covering the ophthalmic artery with a flow-diverting stent is not without potential complications. Ophthalmic complications can occur but are often not diagnosed. The anatomic disposition of the ophthalmic artery in relation to the carotid siphon and aneurysm should be clearly understood because some configurations have a higher risk. When not required, covering of the ophthalmic artery by flow-diverting stents should be avoided.
authors.affiliation: From the Departments of Interventional Neuroradiology (A.R., S.S., Y.C., M.-P.B., C.M.) aymeric.rouchaud@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Rouchaud
authors.affiliation: Ophthalmology (O.L., Y.B., P.-Y.R.), Centre Hospitalier et Universitaire Dupuytren, Limoges, France.
authors.forename: O
authors.initials: O
authors.lastname: Leclerc
authors.affiliation: Ophthalmology (O.L., Y.B., P.-Y.R.), Centre Hospitalier et Universitaire Dupuytren, Limoges, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Benayoun
authors.affiliation: From the Departments of Interventional Neuroradiology (A.R., S.S., Y.C., M.-P.B., C.M.).
authors.forename: S
authors.initials: S
authors.lastname: Saleme
authors.affiliation: From the Departments of Interventional Neuroradiology (A.R., S.S., Y.C., M.-P.B., C.M.).
authors.forename: Y
authors.initials: Y
authors.lastname: Camilleri
authors.affiliation: Institute of Radiology (F.D.), Policlinico Agostino Gemelli, Catholic University, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: D'Argento
authors.affiliation: From the Departments of Interventional Neuroradiology (A.R., S.S., Y.C., M.-P.B., C.M.).
authors.forename: M-P
authors.initials: MP
authors.lastname: Boncoeur
authors.affiliation: Ophthalmology (O.L., Y.B., P.-Y.R.), Centre Hospitalier et Universitaire Dupuytren, Limoges, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Robert
authors.affiliation: From the Departments of Interventional Neuroradiology (A.R., S.S., Y.C., M.-P.B., C.M.).
authors.forename: C
authors.initials: C
authors.lastname: Mounayer
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000601:surgery*; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome