Introduction Carotico-ophthalmic aneurysms represent 5.6% of all intracranial aneurysms¹. Flow diversion has been shown to be effective in the treatment of intracranial aneurysms, demonstrating high rates of occlusion and low complication rates.

Aim of Study The study aimed to assess the efficacy and safety of flow diversion in the treatment of carotico-ophthalmic aneurysms.

Methods Patients from two institutions with carotico-ophthalmic aneurysms treated with flow diversion between 2015 and 2021 were retrospectively analysed. Patient demographics, aneurysm characteristics, clinical outcome, and follow-up imaging were assessed.

Results 106 patients were treated using 10 different types of flow diverter. 97% of patients were female. 28% had hypertension, 27% were active smokers, and 18% were ex-smokers. Three patients were acute presentations. Mean maximum aneurysm width diameter was 7.25mm (1.5 – 25.8) and mean aneurysm neck diameter was 4.36mm (1.2 – 9.46). 30.2% of patients had adjunctive coiling. Complications included intracranial haemorrhage (n = 1), major stroke (n = 2), minor stroke (n = 13) of which all had resolved at 6 months, and groin complications (n = 10). Mortality was <1%. No visual symptoms were reported. 96% of patients received follow-up, with an average follow-up duration of 23.7 months. 94% of patients had complete occlusion (RROC 1) on follow-up imaging, and 100% of patients had adequate occlusion (RROC 1 or 2) on the most recent imaging.

Conclusion The study demonstrates that flow diversion is both effective and safe in the treatment of carotico-ophthalmic aneurysms, providing extremely high rates of occlusion and low rates of morbidity and mortality.

Disclosure of Interest no.