Ophthalmic artery occlusion immediately following placement of a flow diverter without clinical sequelae.
Branch vessel occlusion is a potential consequence following flow diverter placement for intracranial aneurysms, but the frequency and clinical impact has not been completely elucidated. In this case of a 45-year-old woman with a large left internal carotid artery aneurysm, the ophthalmic artery was covered by two flow diverters and was acutely occluded along with the aneurysm. Common carotid injections failed to demonstrate collateral flow to the ophthalmic artery via the external carotid artery. Nonetheless, the patient woke from anesthesia with objectively stable and subjectively improved vision. This case demonstrates that an acute occlusion of the ophthalmic artery without external carotid artery collaterals can be tolerated clinically.
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA.
Justin R
JR
Mascitelli
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA.
Margaret
M
Pain
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA.
Fedor
F
Panov
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA.
Joshua B
JB
Bederson
Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, USA aman.patel@mountsinai.org.
Aman B
AB
Patel
D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002340:Carotid Artery Diseases / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D002533:Cerebral Angiography; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome
Intracranial aneurysm; flow diversion; ophthalmic artery