Introduction: Treatment of ophthalmic segment aneurysms (OSA) remains challenging. Flow Diverter Stent (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. The aim this study was 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 (63.12%) aneurysms with a mean follow-up of 18 months. Complete occlusion was observed in 90 aneurysms (89.1%), near complete occlusion (> 95%) in 3 (2.97%), and incomplete occlusion (< 95%) in 8 aneurysms (7.92%). 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 (7.05%). Permanent morbidity occurred in 4 patients (3.14%) 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.
Patient Care: Flow diverters are a safe and effective endovascular treatment option for ophthalmic segment aneurysms.
Learning Objectives: By the conclusion of this session, participates should be able to discuss the role of flow diversion for ophthalmic segment internal carotid artery aneurysms.