title: Fate of the Ophthalmic Artery After Treatment With the Pipeline Embolization Device.
abstract: BACKGROUND
  Flow diverters have emerged as a major tool in the treatment of cerebral aneurysms. A crucial issue with the use of flow diverters is the patency of side branches covered by the device, most importantly the ophthalmic artery (OA).
  
  
  OBJECTIVE
  To assess the patency of the OA after coverage with the pipeline embolization device (PED).
  
  
  METHODS
  All patients who had a PED covering the OA and in whom angiographic follow-up was available were included in the study. The patency of the OA at follow-up was systematically evaluated by 2 authors who were not involved in the procedure.
  
  
  RESULTS
  Of 95 treated patients, the OA was covered by 1 PED in 81 patients (85%) and by 2 PEDs in 14 patients (15%). Mean angiographic follow-up was 7.5 months, ranging from 3 to 24 months. At the latest follow-up, the OA remained patent in 85 patients (89%), showed diminished flow in 4 patients (4%), and was occluded in 6 patients (7%). Only 1 patient had clinical symptoms related to OA occlusion. In multivariable analysis, larger aneurysm size predicted OA occlusion (P = .04). There was also a strong trend for younger age (P = .06) and coverage by more than 1 device (P = .07).
  
  
  CONCLUSIONS
  Treatment of internal carotid artery aneurysms with the PED preserves the patency of the OA in most cases. The occlusion of the OA in the few cases where it occurs is usually a clinically irrelevant event. Minimizing the number of PEDs across the OA is crucial to preserve its patency.
authors.affiliation: *Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; ‡Department of Neurosurgery, University of Iowa, Iowa City, Iowa.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.forename: Badih
authors.initials: B
authors.lastname: Daou
authors.forename: David
authors.initials: D
authors.lastname: Kung
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Phillips
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.forename: David
authors.initials: D
authors.lastname: Hasan
authors.forename: Adam
authors.initials: A
authors.lastname: Polifka
authors.forename: Sussan
authors.initials: S
authors.lastname: Salas
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Jabbour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D055815:Young Adult