Endovascular Coiling of the Ophthalmic Artery in Pigs to Induce Retinal Ischemia

2011 ◽  
Vol 52 (7) ◽  
pp. 4880 ◽  
Author(s):  
Håkan Morén ◽  
Bodil Gesslein ◽  
Per Undrén ◽  
Sten Andreasson ◽  
Malin Malmsjö
Keyword(s):  
Ophthalmic Artery ◽  
Retinal Ischemia ◽  
Endovascular Coiling

Endovascular treatment of unruptured ophthalmic artery aneurysms: clinical usefulness of the balloon occlusion test in predicting vision outcomes after coil embolization

2015 ◽  
Vol 8 (7) ◽  
pp. 696-701 ◽  
Author(s):  
Byungjun Kim ◽  
Pyoung Jeon ◽  
Keonha Kim ◽  
Narae Yang ◽  
Sungtae Kim ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Coil Embolization ◽  
Collateral Circulation ◽  
Ophthalmic Artery ◽  
Balloon Occlusion ◽  
Endovascular Coiling ◽  
External Carotid ◽  
Occlusion Test ◽  
Balloon Occlusion Test ◽  
Retrograde Filling

BackgroundEndovascular coil embolization for ophthalmic artery (OphA) aneurysms has the latent risk of occlusion of the OphA during the procedure, which can lead to loss of vision. We report clinical and angiographic results of endovascular treatment of OphA aneurysms together with the efficacy of the balloon occlusion test (BOT).MethodsFrom August 2005 to December 2013, 31 consecutive patients with 33 OphA aneurysms were treated in our institution. The patients were classified into two groups according to the location of the OphA within the aneurysmal sac. The BOT was performed in 28 patients using a hypercompliant balloon before endovascular coiling. Collateral circulation between the external carotid artery and the OphA was examined and visual function tests were performed before and after treatment. Patient demographics, angiographic and clinical outcomes were reviewed.ResultsAmong the 28 patients who underwent the BOT, intact collateral circulation was demonstrated in 26 (92.9%) patients and complete occlusion of the OphA was obtained in three patients after coiling. Retrograde filling of the OphA with choroidoretinal blush was observed on post-procedural angiography and no specific visual symptoms were reported during the follow-up period. Complete embolization was achieved in 30 lesions (96.8%) and only five patients (16.1%) had minor recanalization.ConclusionsEndovascular treatment of OphA aneurysms can be performed safely and effectively in conjunction with BOT. The BOT may give useful information to predict visual outcome in patients whose OphA is likely to be threatened by the coiling procedure and to determine the optimal treatment strategy.

Complete Transection of Optic Nerve After Endovascular Coiling of a Large Ophthalmic Artery Aneurysm

2019 ◽  
Vol 132 ◽  
pp. 81-86
Author(s):  
Barbara Verbraeken ◽  
Salah-Eddine Achahbar ◽  
Niels Kamerling ◽  
Laetitia Yperzeele ◽  
Maurits Voormolen ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Complete Transection

Unruptured Ophthalmic Artery Aneurysm Presenting with Vision Loss

2019 ◽  
pp. 61-68
Author(s):  
Harry Van Loveren ◽  
Zeguang Ren ◽  
Pankaj Agarwalla ◽  
Siviero Agazzi
Keyword(s):  
Decision Making ◽  
Ophthalmic Artery ◽  
Vision Loss ◽  
Artery Aneurysm ◽  
Flow Diversion ◽  
Neurological Deficits ◽  
Endovascular Coiling ◽  
Conventional Angiography ◽  
Multiple Treatment ◽  
Technological Advances

Abstract: Intracranial aneurysms pose a significant clinical challenge for cerebrovascular and endovascular neurosurgeons both in treatment decision-making and in the technical aspects. The most important question is whether the aneurysm has ruptured, thereby necessitating urgent treatment. In the unruptured ophthalmic artery aneurysm case with vision loss, the decision to treat rests on understanding the risk of hemorrhage, the success in addressing neurological deficits, and the morbidity of any potential treatment. Computed tomography angiography, conventional angiography, and magnetic resonance imaging are critical and complementary in the diagnosis and management of ophthalmic artery aneurysms, which have also been termed paraclinoid or junctional aneurysms. Due to technological advances, multiple treatment methods are possible, including surgical clipping, endovascular coiling, and flow diversion. Flow diversion is emerging as an effective, less invasive technique with good vision outcomes. This chapter discusses the data behind decision-making, reviews the surgical technique of flow diversion, and emphasizes important aspects of perioperative management.

Recurrent retinal ischemia beyond cervical carotid occlusions

1981 ◽  
Vol 55 (4) ◽  
pp. 532-542 ◽  
Author(s):  
Roger W. Countee ◽  
Thurairasah Vijayanathan ◽  
Pamela Chavis
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Clinical History ◽  
Retinal Ischemia ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Anticoagulant Drug ◽  
Nonsurgical Patients ◽  
Fine Print

✓ Seventeen patients with persistent amaurosis fugax ipsilateral to angiographically documented internal carotid artery (ICA) occlusions in the neck have been treated by the authors over the past 5 years. Complete cerebral arteriography in each case demonstrated that the symptomatic ophthalmic artery was perfused exclusively by the ipsilateral external carotid artery (ECA), which invariably had an obstructive and/or ulcerative lesion at its origin, and/or an adjacent residual “stump” of the occluded ICA. In nine patients, retinal artery branch emboli were visible on funduscopy. One patient had angiographic evidence of intracranial embolization via the ophthalmic artery from the ECA. Although ipsilateral superficial temporal-middle cerebral artery anastomosis in one patient, and endarterectomy of a contralateral carotid stenosis in another patient, failed to relieve symptoms, endarterectomy of the ECA with resection of the “stump” of the occluded ICA effectively terminated symptoms in 10 of 11 patients. Anticoagulant drug therapy promptly abolished symptoms in four nonsurgical patients as well as in two patients with failed operations. It is concluded that recurrent retinal ischemia beyond cervical carotid occlusions frequently results from microembolism via the ipsilateral ECA. Patients with this mechanism of postocclusion recurrent ischemia can be identified on the basis of clinical history, ophthalmological examinations, and complete cerebral arteriography. Termination of embolic phenomena should be the major treatment goal in these individuals, and ECA endarterectomy is recommended. Anticoagulant drugs are an effective alternative treatment in patients who are poor surgical risks.

scholarly journals Ipsilateral Ophthalmic Artery Stenosis in Amaurosis Fugax: A Case Report

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Referano Agustiawan ◽  
Ferdy Iskandar ◽  
Muhammad Ikhsan Mokoagow ◽  
Kanisius Kanovnegara ◽  
Firman Hendrik
Keyword(s):  
Case Report ◽  
Ophthalmic Artery ◽  
Retinal Ischemia ◽  
Artery Stenosis ◽  
First Episode ◽  
Amaurosis Fugax ◽  
Transient Visual Loss ◽  
Ischemic Attack ◽  
The Right ◽  
Untreated Hypertension

Introduction: Amaurosis fugax is caused by an abrupt reduction of blood flow to the retina. Determining the etiology of amaurosis fugax should ensure proper management. Case Report: A 47-year-old female patient who had the first episode of amaurosis fugax in her right eye was referred to our hospital. The amaurosis fugax resolved spontaneously, however, we found a 3 mm long stenosis at her right ophthalmic artery during magnetic resonance angiography. She had clinical histories of untreated hypertension and dyslipidemia. Transient ischemic attack (TIA) was suspected and unfractionated heparin, aspirin, antihypertensive agent, and statin were given. Treatments were maintained, the symptoms had not recurred in the following 6 months after the event. Discussion: Stenosis of the ophthalmic artery is very rare. It occurs in approximately 2% of patient suffering from amaurosis fugax. In our case, stenosis of the right ophthalmic artery due to thromboembolism might cause retinal ischemia leading to a transient visual loss. Conclusion: This case suggests stenosis of ophthalmic artery as the cause of amaurosis fugax. Keywords: amaurosis fugax, ipsilateral, ophthalmic artery, stenosis

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