title: Flow-diversion for ophthalmic segment aneurysms.
abstract: BACKGROUND
  The use of flow-diversion to treat ophthalmic segment aneurysms (OSA) has not been well evaluated.
  
  
  OBJECTIVE
  To assess the visual outcomes, the obliteration rate, and the need for retreatment of OSA treated by the pipeline embolization device (PED).
  
  
  METHODS
  Patients who underwent treatment with PED for OSA from 2009 to 2014 were selected and retrospectively reviewed. Patient's age, sex, mode of presentation, and aneurysm size were recorded. The complication rates, the need for retreatment (due to recurrence of the aneurysm or worsening symptoms), the aneurysm occlusion rates, the evolution of visual symptoms, and the evolution of headache/retro-orbital pain were registered.
  
  
  RESULTS
  Forty-one patients harboring 44 OSA treated by flow-diversion were identified. Females constituted 87.80% (37/41) of the cohort. The mean age was 59.16 ± 12.54 years. At final angiographic follow-up, 77.27% (34/44) had complete occlusion, 6.81% (3/44) had near-complete occlusion, and 15.90% (7/44) had incomplete occlusion. Of the 22 symptomatic OSA, complete resolution or significant improvement was noted in 72.72% (16/22), while worsening of symptoms occurred in 4.54% (1/22). Five patients out of 22 (22.72%; 5/22) had no significant changes in their symptoms. The complication rate was 2.27% (1/44). The mortality rate was 0%.
  
  
  CONCLUSIONS
  The low complication rate, the high obliteration rate, and the high rate of improvement in the visual symptoms make flow-diversion an appealing option for the treatment of OSA.
authors.affiliation: *Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; ‡Department of Neurosurgery, University of Virginia, Charlottesville, Virginia; §Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.forename: Guilherme
authors.initials: G
authors.lastname: Barros
authors.forename: Eric Winthrop
authors.initials: EW
authors.lastname: Schwartz
authors.forename: Mark Philip
authors.initials: MP
authors.lastname: Saigh
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.forename: Alex
authors.initials: A
authors.lastname: Whiting
authors.forename: Stavropoula I
authors.initials: SI
authors.lastname: Tjoumakaris
authors.forename: David
authors.initials: D
authors.lastname: Hasan
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome