Surgical treatment of carotid-ophthalmic aneurysm

Objective To explore the anatomical features of carotid ⁃ ophthalmic aneurysm and clinoid process and the surgical technique and outcome. Methods In this study there were 15 patients with carotid ⁃ ophthalmic aneurysm (12 patients ophthalmic aneurysm, 1 superior hypophsial aneurysm, 2 dorsal internal carotid aneurysm). Patients were treated by clipping procedure through pterional approach. During the procedure, intra⁃ and extra⁃cranial internal carotid arteries were temporarily occluded. Results Postoperative digital subtraction angiography (DSA) or CT angiography (CTA) examinations showed that the effect of clipping treatment was satisfactory in 13 patients, the blood flow was good in parent artery and distal artery. Visual acuity was improved in 2 cases with visual disturbance. After surgery only one case presented hemiparesis of contralateral limb. No severe operative ⁃ related complications occurred. All patients were followed up for 3-10 months (average 5 months) after surgery. The recovery was good. Conclusion Pterional approach combined with temporary blocking of intra ⁃ and extra ⁃ cranial internal carotid artery is an effective and safety surgical method for treating carotid⁃ophthalmic aneurysm. During operation, fluorescence imaging can immediately indicate whether there are residual aneurysm and narrow parent artery, so that it can help the physician to adjust the clipping procedure and achieve satisfactory effect. DOI：10.3969/j.issn.1672-6731.2011.02.018