Outcome following surgery for ophthalmic segment aneurysms

Indocyanine green videoangiography in clipping of paraclinoid aneurysms

“…Under ICG videoangiography, real time blood flow vortices can be witnessed. Many papers have been published on surgery for paraclinoid aneurysms (2)(3)(4)6,7,9,(13)(14)(15)18). The mean age of the patients in these studies is 42-50 years and the SAH rate is 0-80.8%, with mostly large and giant but some small aneurysms, which are comparable to those in our study.…”

“…Sherif et al (14) Indications for microsurgery were: superior aneurysm projection, giant/large or wide necked aneurysms and aneurysms at branching sites. Indications for embolisation were: narrow necks, neck calcification, close aneurysm relation to the clinoid process or adhesion to the distal dural ring, and aneurysm location in the concavity of the carotid siphon curve.…”

“…Combined with the use of near-infrared video technology in current microscopes, surgeons can evaluate intraoperative blood flow with a simple intravenous injection. Previous studies have reported its use in cerebral arteriovenous malformations, aneurysms, and extracranial-intracranial bypasses with good results (12)(13)(14)(15)(16)(17). This study is dedicated to present our experience with the use of ICG videoangiography in surgical clipping of paraclinoid aneurysm.…”

Vision Outcomes and Major Complications after Endovascular Coil Embolization of Ophthalmic Segment Aneurysms

“…Even with the development of microsurgical techniques, the reported morbidity in the literature during the past 5 years ranged from 9% to 39%, with an average of 21% for 381 patients. 3,6,10,17,18,23,29 Although this study does not directly compare endovascular and open surgical techniques, the studies that have made this comparison have demonstrated an endovascular complication rate ranging from 0% to 18%, with an average of 4.5% for 358 aneurysms, while the surgical complication rate ranged from 3.7% to 27.5% with an average of 11.2% for 402 aneurysms. 3,5,15,16 Of the 65 unruptured aneurysms, 55% were occluded primarily.…”

Microsurgical treatment of ophthalmic segment aneurysms

“…Although narrow-necked aneurysms are ideal endovascular targets, 1 more complex and larger lesions necessitating adjunctive stent 2 or flow-diversion techniques 3 may be suitably treated with long-lasting, effective clip ligation instead -a particularly important consideration for ruptured aneurysms. [4][5][6] Their microsurgical management is more nuanced than aneurysms arising more distally along the internal carotid artery (ICA) or at the middle cerebral artery bifurcation; however a mastery of key principles of proximal control, sharp dissection, and intradural anterior clinoidectomy can afford excellent results. 4 …”