Role of the ophthalmic artery in the endovascular treatment for intracranial vascular diseases

Hou, Kun; Wu, Wei; Liu, Ying; Qu, Lai; Xu, Bin; Yu, Jinlu

doi:10.1007/s13760-020-01576-z

Cited by 7 publications

(6 citation statements)

References 70 publications

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“…Facial numbness, as a form of cranial nerve damage, resulted from the dangerous anastomosis of the MMA, in which the liquid material enters the feeder to affect the geniculate ganglion (16). In the case of blindness, the liquid material entered the ophthalmic artery via the MMA (17). If the fistula ruptures during EVT under the high pressure of Onyx casting or if too many draining veins are occluded, intracranial hemorrhage may occur.…”

Section: Discussionmentioning

confidence: 99%

Is the Middle Meningeal Artery the Optimal Path for Dural Arteriovenous Fistula Embolization?

Wang

et al. 2021

Front. Neurol.

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Background: The middle meningeal artery (MMA) is the optimal arterial path for endovascular treatment (EVT) of dural arteriovenous fistulas (DAVFs). However, the details are not completely understood.Materials and Methods: We performed a retrospective study of patients who were admitted to the First Hospital of Jilin University with a diagnosis of cranial DAVF with involvement of the MMA as a feeding artery. On the basis of the arterial path chosen and the role of the MMA in the first EVT procedure, EVT was divided into three types (I–III), each of which was further divided into two subclasses (a and b). The degree of embolization was analyzed.Result: The 104 included patients ranged in age from 13 to 80 years (mean, 53.6 ± 11.8 years). There were 48 cases of hemorrhage (46.2%, 48/104). Complete embolization was achieved in the first procedure in 64.4% of cases, and success was eventually achieved using EVT (the first attempt or a subsequent attempt) in 74.1% of cases. EVT caused complications in 6.7% of cases. A modified Rankin scale score of 0 or 1 was achieved in 78.8% of patients. Statistical analyses revealed that type Ia and IIb EVTs had the lowest complete embolization rates, but no difference was found between type Ia and IIb EVTs. Types IIa and III EVT had the highest complete embolization rates. Most cases had a good prognosis.Conclusion: These findings elucidate the features of the different EVT classes defined by the first EVT procedure and the role of the MMA. The delivery of treatment via slim and tortuous MMA branches increased the failure rate of EVT. A thick, straight MMA branch is the optimal path for treatment.

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Section: Discussionmentioning

confidence: 99%

Is the Middle Meningeal Artery the Optimal Path for Dural Arteriovenous Fistula Embolization?

Wang

et al. 2021

Front. Neurol.

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“…Collateral circulation between external carotid artery (ECA) branches and OphA may be apparent or potential, varying from 36 to 89% of cases with ICA occlusion (41,42). The balloon occlusion test (BOT) can identify collateral circulation (43).…”

Section: Evt Consideration Based On the Collateral Circulation Of The...mentioning

confidence: 99%

Endovascular treatment of aneurysms of the paraophthalmic segment of the internal carotid artery: Current status

Wang

2022

Front. Neurol.

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The paraophthalmic segment of the internal carotid artery (ICA) originates from the distal border of the cavernous ICA and terminates at the posterior communicating artery. Aneurysms arising from the paraophthalmic segment represent ~5–10% of intradural aneurysms. Due to the advent of endovascular treatment (EVT) techniques, specifically flow-diverting stents (FDSs), EVT has become a good option for these aneurysms. A literature review on EVT for paraophthalmic segment aneurysms is necessary. In this review, we discuss the anatomy of the paraophthalmic segment, classification of the paraophthalmic segment aneurysms, EVT principle and techniques, and prognosis and complications. EVT techniques for paraophthalmic segment aneurysms include coil embolization, FDSs, covered stents, and Woven EndoBridge devices. Currently, coiling embolization remains the best choice for ruptured paraophthalmic segment aneurysms, especially to avoid long-term antiplatelet therapy for young patients. Due to the excessive use of antiplatelet therapy, unruptured paraophthalmic segment aneurysms that are easy to coil should not be treated with FDS. FDS is appropriate for uncoilable or failed aneurysms. Other devices cannot act as the primary choice but can be useful auxiliary tools. Both coiling embolization and FDS deployment can result in a good prognosis for paraophthalmic segment aneurysms. The overall complication rate is low. Therefore, EVT offers promising treatments for paraophthalmic segment aneurysms. In addition, surgical clipping continues to be a good choice for paraophthalmic segment aneurysms in the endovascular era.

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“…Vzácně může být AO větví arteria carotis externa, jiného segmentu ACI či dokonce jiné intrakraniální tepny. Ve svém průběhu má četné anastomózy mezi intrakraniálním a extrakraniálním cévním řečištěm [21].…”

Section: Cévní Zásobení Sítnice a Patogeneze Craounclassified

“…Tato dvě zúžení představují nejpravděpodobnější místa usazení embolu při CRAO [24]. ACR je konečnou artérií a nemá žádné významné anastomózy [21]. U 10-30 % populace existuje variantní zásobení makulární oblasti prostřednictvím arteria cilioretinalis.…”

Section: Cévní Zásobení Sítnice a Patogeneze Craounclassified

Intravenous Thrombolytic Therapy for Acute Nonarteritic Central Retinal Artery Occlusion. A Review

Janská¹,

Bodnár²,

Jánský³

et al. 2022

CSO

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Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke. It is a critical condition that often leads to severe visual loss or blindness and can be a harbinger of further cerebrovascular events. Due to the lack of scientific data, there are no effective evidence-based forms of therapy for this condition. None of the conservative therapies have proven effective. The results of some previously published studies suggest a benefit of intravenous thrombolytic therapy in the same regimen as in the treatment of ischemic stroke. This work aims to present an overview of published clinical studies focused on the use of intravenous thrombolysis for CRAO, evaluate its efficacy and safety, and propose an optimal diagnostic and therapeutic algorithm for acute management of CRAO. Summary statistics of patient data from relevant studies indicate that a significant visual acuity improvement was achieved by a total of 45 % of patients receiving alteplase within 4.5 hours of symptoms onset. The occurrence of adverse events in this time window was not significant. Intravenous thrombolytic therapy in CRAO thus appears to be effective and safe. However, we still lack data from adequate prospective randomized controlled trials to confirm this conclusion. To date, two randomized trials are being conducted. The intravenous thrombolysis administration, patient monitoring, etiologic workup, and setting of effective secondary prevention should be ensured at the centre of highly specialized cerebrovascular care. Urgent transport of the CRAO patient to the nearest centre is essential.

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Role of the ophthalmic artery in the endovascular treatment for intracranial vascular diseases

Cited by 7 publications

References 70 publications

Is the Middle Meningeal Artery the Optimal Path for Dural Arteriovenous Fistula Embolization?

Is the Middle Meningeal Artery the Optimal Path for Dural Arteriovenous Fistula Embolization?

Endovascular treatment of aneurysms of the paraophthalmic segment of the internal carotid artery: Current status

Intravenous Thrombolytic Therapy for Acute Nonarteritic Central Retinal Artery Occlusion. A Review

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