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Balloon Occlusion Testing to Assess Retinal Collateral and Predict Visual Outcomes in the Management of a Fusiform Intraorbital Ophthalmic Artery Aneurysm: Technical Note and Literature Review
- Source :
- Operative Neurosurgery. 16:E60-E66
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background and importance Aneurysms of the ophthalmic artery (OA) within the orbit and optic canal are extremely rare. Given the peripheral location of these aneurysms and the fact that most are fusiform, parent artery occlusion is preferred for symptomatic aneurysms. However, the impact of OA occlusion on vision is not always innocuous. Balloon occlusion testing (BOT) of the OA has the potential to gauge the possibility of visual compromise, in addition to assessing collaterals. While BOT has been assessed for carotid artery occlusion, its role in OA occlusion has not been well defined. Clinical presentation We describe a patient with a 6-mm intracanalicular OA aneurysm who was treated with endovascular coil embolization of the aneurysm and occlusion of the parent artery. We performed a 30-min balloon occlusion test, in which we verified intact visual and neurological function. Collateral vascularity was confirmed. Complete occlusion was achieved and the patient recovered with intact visual and neurological function. We provide a review of literature pertaining to parent artery occlusion of OA aneurysms that occur within optic canal and orbit. A brief note on anatomy of OA and collaterals is provided. Conclusion Endovascular parent artery occlusion is an effective treatment for OA aneurysms that occur in optic canal and orbit. Assessment of effect of occlusion on vision is important. BOT can assess this and provide valuable information. Recovery or preservation of visual function is highly dependent on preoperative visual status.
- Subjects :
- Male
medicine.medical_specialty
genetic structures
medicine.medical_treatment
Vision Disorders
Collateral Circulation
030218 nuclear medicine & medical imaging
Ophthalmic Artery
03 medical and health sciences
0302 clinical medicine
Aneurysm
medicine.artery
Occlusion
Humans
Medicine
cardiovascular diseases
Embolization
Intraoperative Care
medicine.diagnostic_test
Optic canal
business.industry
Endovascular Procedures
Intracranial Aneurysm
Balloon Occlusion
Middle Aged
medicine.disease
Collateral circulation
Embolization, Therapeutic
eye diseases
Cerebral Angiography
Carotid Arteries
medicine.anatomical_structure
Ophthalmic artery
Carotid artery occlusion
cardiovascular system
Surgery
Neurology (clinical)
Radiology
business
030217 neurology & neurosurgery
Cerebral angiography
Subjects
Details
- ISSN :
- 23324260 and 23324252
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Operative Neurosurgery
- Accession number :
- edsair.doi.dedup.....1d08eb008d2b865367da205bb01968c2