Flow Diverters for Treatment of 160 Ophthalmic Segment Aneurysms: Evaluation of Safety and Efficacy in a Multicenter Cohort.
BACKGROUND
Treatment of ophthalmic segment aneurysms (OSA) remains challenging. Flow diverter stents (FDS) have evolved as a promising endovascular treatment option for aneurysms of the internal carotid artery and are associated with high occlusion rates and a favorable morbidity and mortality profile.


OBJECTIVE
To determine safety and efficacy of FDS for OSA in a large, multicenter cohort.


METHODS
A retrospective analysis of prospectively maintained databases of 127 consecutive patients harboring 160 OSA treated with FDS was performed. Aneurysms were classified based on location and morphology. Follow-up with digital subtraction angiography (DSA) was performed 6 to 18 months after treatment.


RESULTS
Follow-up DSA was available for 101 (63.1%) aneurysms with a mean follow-up of 18 months. Complete occlusion was observed in 90 aneurysms (89.1%), near-complete occlusion (>95%) in 3 (3%), and incomplete occlusion (<95%) in 8 aneurysms (7.9%). One aneurysm was retreated with another FDS (0.9%). No risk factors for incomplete occlusion were identified. The OA was occluded at the latest follow-up in 6 cases (7.1%). Permanent morbidity occurred in 4 patients (3.1%), and there was no mortality related to the FDS procedure.


CONCLUSIONS
Treatment of OSA with FDS was found to be safe and effective. The retreatment rate was extremely low and aneurysms that occluded did not reanalyze.
Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Christoph J
CJ
Griessenauer
Hospital Beneficência Portuguesa de São Paulo, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Ronie L
RL
Piske
Hospital Beneficência Portuguesa de São Paulo, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Carlos E
CE
Baccin
Hospital Beneficência Portuguesa de São Paulo, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Benedito J A
BJA
Pereira
Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.|Department of Radiology, Edward Hines Jr. Veterans Affairs Hospital, Chicago, Illinois.
Arra S
AS
Reddy
Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Ajith J
AJ
Thomas
Hospital Beneficência Portuguesa de São Paulo, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Thiago G
TG
Abud
Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Christopher S
CS
Ogilvy
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000379:methods / Q000592:standards; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D011446:Prospective Studies; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents / Q000592:standards*; D016896:Treatment Outcome
Aneurysm; Endovascular; Internal carotid artery