ENDOVASCULAR TREATMENT OF OPHTHALMIC SEGMENT ANEURYSMS WITH GUGLIELMIDETACHABLE COILS

PURPOSE: To evaluate the safety and efficacy of endovascular treatment of ophthalmic segment aneurysms with Guglielmi detachable coils (GDCs ), as well as the primary indications for such treatment. METHODS: We conducted a prospective study of 26 patients with 28 aneurysms of the ophthalmic segment in whom treatment with GDCs was attempted. Anatomic results were measured by statistical analysis of variance for such fa ctors as age, sex, presence of subarachnoid hemorrhage, anatomic type (ophthalmic or superior hypophyseal), size of aneurysmal sac, and widt h of aneurysmal neck. Clinical evaluation and control angiography were performed at 6 and 18 months. RESULTS: Overall, complete occlusion wa s obtained in 14 aneurysms (50%) and small residual necks were left in 11 aneurysms (39%), Three treatment attempts failed (11%). Complete o cclusion was obtained in 76% of small-necked aneurysms as opposed to 9 % of aneurysms with a large neck. The best predictor of anatomic resul t was the size of the aneurysmal neck. Complete occlusion was obtained in 85% of superior hypophyseal aneurysms of the paraclinoid variant. One permanent complication was related to treatment. CONCLUSION: Endov ascular treatment with GDCs appears to be a safe and efficient alterna tive approach for ophthalmic segment aneurysms, especially for paracli noid variants of superior hypophyseal aneurysms, which tend to have a small neck.