Early and mid term results of ophthalmic segment aneurysm endovascular treatment a single center experience

Purpose: Surgical treatment of ophthalmic segment aneurysms is difficult because of its anatomical location and proximity of the optic apparatus and cavernous sinuses. Minimally invasive treatment methods in the relevant blood vessel are very essential to reduce the risk of complications. Technological advances in the endovascular field have improved the effectiveness of the procedure, making this treatment method increasingly popular, and as the experience of specialists increases,the results of therapy improve. The purpose of this retrospective single center study was to evaluate early and mid-term occlusion rate using Raymond-Roy occlusion scale (RROC), and assess endovascular treatment efficacy after 6 month follow-up. Materials and methods: 41 patients who have undergone endovascular treatment of internal carotid artery C6 segment aneurysms from 2016 to 2023 in Pauls Stradins Clinical University Hospital were enrolled. Early and midterm DSA and 3D-DSA imaging results were examined. Patient demographic data, clinical data (size, degree of occlusion (RROC) and location of aneurysms of the C6 segment of the internal carotid artery), procedure data on the applied treatment method were obtained and recorded from the medical documentation.
Results: The study collected data from 41 patients of whom 33 were female (80.5%). 31 (75.6%) patients were above 50 years, the mean age was 55,2 (+/- 11,4 years). The mean size of aneurysm sac in early term results was 5,96 (+/- 3,11 mm), in mid-term results 5,78 (+/- 3,4 mm), there was a reduction in size, this change was not statistically significant. Mean size of aneurysm neck in early term results was 4,01 (+/- 1,23 mm), in mid-term results 3,73 (+/- 1,20 mm), change was statistically significant (p<0,001). Average sack/neck ratio in early term results was 1,45 (+/- 0,39 mm), in mid-term results 1,49 (+/- 0,42 mm), change was not statistically significant. In early control complete aneurysm occlusion (RR I) was achieved for 18 (43.9%) patients, and in mid-term control complete aneurysm occlusion was seen in 34 (82.9%) patients. Residual aneurysm neck (RR II) in early control was observed in 18 (43.9%) patients, but in mid-term control the number of patients decreased to 6 (14.6%) patients. Residual sac (RR III), was observed in 5 (12.2%) patients in the early results, but only in 1 (2.4%) patient in the midterm follow-up. Conclusion: This study emphasizes the efficacy of endovascular treatment in early and mid-term follow-up, seeing positive results in occlusion and changes in aneurysm size. In future research extension of observation period of the aneurysm itself and the long-term effects of the embolized aneurysm on the surrounding structures should be evaluated.