P060/83 Outcomes and safety of flow diverter stents for carotico-ophthalmic aneurysms

Introduction

Carotid-ophthalmic aneurysms represent 0.3–1% intracranial and 0.9–6.5% ICA aneurysms. Optimal management is currently contentious.

Aim of Study

Reviewing outcome and safety of flow divertors stents (FDS) for Carotid-Ophthalmic aneurysms.

Methods

Retrospective data between 2015 and 2021 was collected from CRIS/PPM/PACS databases for 64 carotid-ophthalmic aneurysms treated with FDS +/- coiling in Leeds General Infirmary.

Results

Sixty-three (98%) patients were female. Mean age was 57 (29–77). Twenty (31%) were hypertensive. Fifteen (23%) were smokers and seven (11%) ex-smokers. Presentations were predominantly incidental (51/64, 80%). Others included six visual symptoms, six elective re-stents and an embolised, partially thrombosed aneurysm. Ten (16%) aneurysms were partially thrombosed on presentation. Mean aneurysm dimensions were: neck diameter 4.69 mm (2.08–9.46); maximum width 8.55 mm (2.78–25.8); dome height 8.26 mm (2.32–27.7); Dome-to-Neck Ratio 1.79 (1–4.28). Twenty-four Supass, 23 Pipeline, 17 P64 and 1 Silk stent were used. One patient required two stents. Seventeen (27%) aneurysms were coiled completely and 6 (9%) partially. Modal hospital stay was 1 day (1–228). Sixty-one (95%) patients stayed ≤7 days. Mean follow-up time was 23.4 months (3.3–61.2). Sixty-one patients had follow-up. Fifty-nine (97%) had complete occlusion. All occlusions were adequate.

Complication rates improved over time

Complications included groin haematomas (6), minor stroke (4), intracranial bleed (1) and death (1). No new/worsening visual complications occurred. Modified Rankin Score was >1 in 4 patients post-discharge and 1 patient at 6 months.

Conclusion

FDS offers excellent outcomes and safety. Further intervention (routine antiplatelet testing, stent sizing software, reducing antiplatelet regime to 1 year) may optimise results.

Disclosure of Interest

Nothing to disclose