Asymptomatic, Unruptured Carotid-Ophthalmic Artery Aneurysms: Angiographical Differentiation of Each Type, Operative Results, and Indications

Kumon, Yoshiaki; Sakaki, Saburo; Kohno, Kanehisa; Ohta, Shinsuke; Ohue, Shiroh; Oka, Yoshihisa

doi:10.1016/s0090-3019(97)00175-4

Cited by 62 publications

(32 citation statements)

References 10 publications

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“…In the treatment decision making, the neurovascular team takes into account the benefit-to-risk ratio among 3 therapeutic options: conservative, endovascular, or surgical. The rates of morbidity and mortality related to endovascular and surgical treatment of asymptomatic aneurysms are, respectively, 1% and 4% 6,22 and 2.6% and 10.9%, 22,23 the surgical morbidity being slightly higher for PA. 24 The spontaneous risk of rupture of these aneurysms (sizes are approximately 6 mm and are located on the anterior circulation) varies between 0.05% and 0.5% per year, whether there is a previous history of SAH from an associated aneurysm (7/17 cases in this study). 25 In women with a mean age of 45 years and a life expectancy of approximately 84 years, the cumulative risk of rupture (conservative treatment) can reach 1.8% to 18% and is not so different from the risk of endovascular or surgical treatment, especially if there are individual risks of aneurysmal growth such as arterial hypertension, smoking, or a familial history of SAH or connective tissue disease.…”

Section: Value and Limitations Of The Pmpmentioning

confidence: 68%

Usefulness of MR Imaging for the Assessment of Nonophthalmic Paraclinoid Aneurysms

Thines¹,

Gauvrit²,

Leclerc³

et al. 2007

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The neuroradiologic location of asymptomatic paraclinoid aneurysms is decisive for patient management. In a preliminary study, we designed a paraclinoid MR protocol (PMP) including high-resolution T2-weighted images in 2 orthogonal planes to define the inferior limit of the distal dural ring plane that represents the borderline between the intradural and extradural internal carotid artery. In this clinical study, we compared this protocol with digital subtraction angiography (DSA) for the location of paraclinoid aneurysms.

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Section: Value and Limitations Of The Pmpmentioning

confidence: 68%

Usefulness of MR Imaging for the Assessment of Nonophthalmic Paraclinoid Aneurysms

Thines¹,

Gauvrit²,

Leclerc³

et al. 2007

AJNR Am J Neuroradiol

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“…Die Nähe paraophthalmischer Aneurysmen zu den umliegenden Strukturen einschließlich der A. ophthalmica und des N. opticus kann selbst erfahrene vaskuläre Neurochirurgen vor technische Herausforderungen stellen [11][12][13]. Eine unmittelbare mechanische Verletzung des N. opticus kann Anlass zur Sorge sein.…”

Section: Chirurgische Behandlungunclassified

“…Eine unmittelbare mechanische Verletzung des N. opticus kann Anlass zur Sorge sein. Die Entfernung des vorderen Klinoidfortsatzes kann mit einer erheblichen Wärmeentstehung und dadurch mit thermischer Schädigung des N. opticus einhergehen [13]. Trotz dieser mög-lichen technischen Schwierigkeiten sind die operativen Ergebnisse, soweit sie in der Literatur berichtet werden, akzeptabel [14][15][16][17][18].…”

Section: Chirurgische Behandlungunclassified

Management paraophthalmischer Aneurysmen

Bhogal

Pérez

Sauder³

et al. 2017

Ophthalmologe

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“…Direct surgery is often difficult depending on the anatomical characteristics of the site of the lesion (anterior clinoid process, cavernous sinus), 1,2) and high morbidity and mortality have been reported. 3) Endovascular treatment has advantages over direct surgery including a low complication rate, but cases of incomplete occlusion and those requiring retreatment have been reported as problems.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Embolization of Large Internal Carotid Artery Aneurysms: Single-center Experience with 10 Cases and Literature Review

Aoyama

Shigeta

Sato

et al. 2017

JNET

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Objective:We reviewed the treatment results of internal carotid artery (ICA) aneurysms with a maximum diameter of 10 mm or greater for the future selection of patients with indications for Pipeline Flex (Medtronic, Irvine, CA, USA). Methods:The treatment methods, treatment effects, complication rate, and retreatment rate were studied in lesions that were treated by coil embolization but are presently considered indications for treatment using Pipeline Flex among the 516 cerebral aneurysms treated at our hospital between July 2009 and May 2016. We also reviewed the literature concerning coil embolization for large and giant aneurysms and examined the results of coil embolization for aneurysms with indications for Pipeline. Results:The subjects were 10 patients consisting of 5 with asymptomatic unruptured aneurysm, 2 with symptomatic unruptured aneurysm, and 3 patients with recurrence after treatment for ruptured aneurysm. The mean size of the aneurysms was 12.8 mm (10.5-17.8 mm), and the mean follow-up period was 49.1 ± 13.4 months. The treatments were balloon-assisted coil embolization in eight patients and stent-assisted coil embolization in two patients. None showed postoperative symptomatic ischemic lesions, and the permanent morbidity was 0%. Of the two patients with symptomatic aneurysms, the symptoms were alleviated after treatment in one patient, and retreatment was necessary in one patient.In the review of the literature, comparisons were made in 69 large or giant aneurysms treated by coil embolization between those with and without indications for Pipeline. The additional treatment rate was significantly lower in the lesions with indications for Pipeline (33.3% vs. 61.9%, P = 0.02). The retreatment rate was significantly lower at 15.4%, particularly in extradural aneurysms (Bouthillier C4, 5). Conclusion:The results of this study suggest that the retreatment rate after conventional coil embolization for extradural unruptured large cerebral aneurysms was not high and that coil embolization is worth considering for asymptomatic aneurysms at these sites 10-15 mm in diameter.

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Asymptomatic, Unruptured Carotid-Ophthalmic Artery Aneurysms: Angiographical Differentiation of Each Type, Operative Results, and Indications

Cited by 62 publications

References 10 publications

Usefulness of MR Imaging for the Assessment of Nonophthalmic Paraclinoid Aneurysms

Usefulness of MR Imaging for the Assessment of Nonophthalmic Paraclinoid Aneurysms

Management paraophthalmischer Aneurysmen

Endovascular Embolization of Large Internal Carotid Artery Aneurysms: Single-center Experience with 10 Cases and Literature Review

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