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Incomplete occlusion and visual symptoms of peri-ophthalmic aneurysm after treatment with a pipeline embolization device: a multi-center cohort study

  • Original Article - Vascular Neurosurgery - Aneurysm
  • Published:
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Abstract

Objective

Peri-ophthalmic aneurysm is a special type of aneurysm. We assessed the relationship between ophthalmic artery (OA) origin and aneurysm and examined the effect of a pipeline embolization device (PED, Covidien/Medtronic) with or without coils on aneurysm occlusion rate and visual outcomes.

Methods

We retrospectively analyzed 194 peri-ophthalmic aneurysms in 189 patients among 1171 patients treated with a PED in a Chinese post-market multi-center registry study from November 2014 to October 2019. Peri-ophthalmic aneurysms were defined as carotid–ophthalmic segment aneurysms arising from the internal carotid artery dorsal wall at, or distal to, the OA origin, with a superior or superomedial projection. The relationship between OA origin and the aneurysm was classified as follows: type A, OA originating separate from the aneurysm; type B, OA originating from the aneurysm neck or dome. Patients with aneurysm were divided into the PED-only group and the PED + coils group according to treatment.

Results

The median follow-up time was 6.8 months (range, 5.3–20.2 months). There were 163 occluded aneurysms (84%) and 31 aneurysms with incomplete occlusion (16%). A multivariate analysis showed that type B aneurysm was a risk factor for incomplete occlusion in the PED-only group (odds ratio [OR] 4.854, 95% confidence interval [CI] 1.878–12.548, P = 0.001). Visual symptoms at final follow-up correlated with preoperative visual symptoms (OR 22.777, 95% CI 3.115–166.555, P = 0.002).

Conclusions

Type B aneurysm is associated with a lower occlusion rate after PED-only treatment. Patients with preoperative visual symptoms should be treated promptly to avoid permanent visual symptoms.

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Data availability

All the data of this study can be obtained in the article and supplementary materials.

Code availability

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Funding

This study was funded by National Nature Science Foundation of China (Grant no. 82071309), National Natural Science Foundation of China (Grant no. 81901190), and Natural Science Foundation of Heilongjiang Province of China (Grant no. YQ2019H015).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, No. 23, Youzheng Street, Nangang District, Heilongjiang Province, 150001, Harbin, People’s Republic of China

    Chao Xu, Pei Wu, Bowen Sun, Shancai Xu & Huaizhang Shi

  2. Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China

    Bin Luo

  3. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China

    Xinjian Yang

Authors
  1. Chao Xu
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  2. Pei Wu
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  5. Bin Luo
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Contributions

Conception and design: CX, PW. Acquisition of data: CX, PW, BL. Analysis and interpretation of data: CX, BS, BLuo. Drafting the article: CX. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: HS. Statistical analysis: CX, SX. Study supervision: HS, XY.

Corresponding author

Correspondence to Huaizhang Shi.

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Ethics approval

This trial was approved by the Institutional Review Board (IRB) of Beijing Tiantan Hospital Affiliated to Capital Medical University. Ethical review No: KY 2018–098-02.

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This trial was registered with ClinicalTrials.gov identifier: NCT03831672 and waiver of one or more elements of informed consent.

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The authors declare that there is no conflict of interest regarding the publication of this paper.

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The authors declare no competing interests.

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This article is part of the Topical Collection on Vascular Neurosurgery - Aneurysm

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Xu, C., Wu, P., Sun, B. et al. Incomplete occlusion and visual symptoms of peri-ophthalmic aneurysm after treatment with a pipeline embolization device: a multi-center cohort study. Acta Neurochir 164, 2191–2202 (2022). https://doi.org/10.1007/s00701-022-05239-1

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  • DOI: https://doi.org/10.1007/s00701-022-05239-1

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