Introduction/purpose The purpose of this study was to determine the efficacy and safety of flow diversion technology in the treatment of aneurysms of carotid-ophthalmic aneurysms.

Materials and methods This study retrospectively reviewed outcomes in 45 consecutive patients with carotid-ophthalmic aneurysms who were treated with Pipeline Embolization Device (PED) by three separate neuro-interventionalists. A chart review was performed to collect information on demographics, aneurysm size, treatment outcomes, and procedure-related complications. The primary end-points were rate of aneurysm occlusion and ophthalmic artery patency, as assessed by angiographic images. The secondary end point was peri- and post-procedural complications were evaluated. Descriptive statistical analysis was performed.

Results There were 39 females and 6 males in the study. The average age was 56.4 (range 31–81). Thirty-two patients had a single aneurysm treated during the PED procedure; multiple aneurysms were treated in 13 cases. All of the aneurysms treated were unruptured. Seven aneurysms were recurrences of prior coil embolization procedures. The average aneurysm size was 8.9 mm (range 2.1–26). The treated aneurysm measured <10 mm in 28 cases. The average neck size was 5.3 mm (range 1.6–9.3 mm). Patients were treated with one PED in 32 cases, two PEDs in 10 cases, three PEDs in 2 cases, and four PEDs in 1 case. Eleven cases were treated with coiling in addition to PED placement.

The PED was successfully deployed in 44 of 45 cases. There were two mortalities (4.4%) within 30 days of treatment-one from a large intraparenchymal haemorrhage and one from unknown causes. Other 30-day complications included capture coil fracture (2), reversible intra-procedural thrombosis (2), small contralateral convexity subarachnoid haemorrhage (1), and symptomatic embolic infarcts (1). There were no complications seen after 30 days.

Six month angiographic follow-up was available in 37. There was complete aneurysm occlusion in 27 patients (73%). There was minimal residual aneurysm filling in eight patients (22%) and only slightly decreased aneurysm filling in two patients (5%). There was only one instance (3%) of ophthalmic artery occlusion noted, and this was asymptomatic.

Conclusion Flow diversion treatment for carotid-ophthalmic aneurysms has a high rate of aneurysm occlusion, while maintaining a low complication rate.

Disclosures J. Grossberg: None. F. Tong: None. C. Cawley: None. J. Dion: None.