Endovascular retrograde suction decompression as an adjunct to surgical treatment of ophthalmic aneurysms: Analysis of risks and clinical outcomes

Daniel H. Fulkerson, Terry C. Horner, Troy D. Payner, Thomas J. Leipzig, John A. Scott, Andrew J. Denardo, Kathleen Redelman, Julius M. Goodman

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

OBJECTIVE: Endovascular retrograde suction decompression with balloon occlusion of the internal carotid artery is a useful adjunct in the surgical treatment of ophthalmic aneurysms. This technique helps establish proximal control, facilitates intraoperative angiography, and may aid dissection by evacuating blood and softening the aneurysm. Although the technical aspects of this procedure have been described, the published data on its safety are scant. This study analyzed 2 groups of patients who underwent craniotomies for treatment of ophthalmic aneurysms, comparing a group who received suction decompression with a group who did not. METHODS: A retrospective analysis of prospectively collected data on 118 craniotornies for ophthalmic aneurysms performed from 1990 to 2005 is presented. A group of 63 patients treated with endovascular suction decompression during surgery is compared with 55 patients who did not undergo this technique. RESULTS: In our overall analysis of ophthalmic aneurysms, the clinical outcome was sta-tistically related to aneurysm size (P = 0.046). The endovascular suction decompression group in this study had overall larger aneurysms (P < 0.0001) compared with the other group. There was no statistical difference between the 2 groups in rates of complications, stroke, new visual deficit, or death. The clinical outcomes were statistically similar at discharge and at 1 year. CONCLUSION: Endovascular balloon occlusion and suction decompression did not increase the complication rate in a large cohort of craniotomy patients with ophthalmic aneurysms. This technique may be used to augment surgical capabilities without significantly increasing the operative risk.

Original languageEnglish (US)
Pages (from-to)ons107-ons111
JournalNeurosurgery
Volume64
Issue number3 SUPPL.
DOIs
StatePublished - Mar 1 2009

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Keywords

  • Balloon occlusion
  • Endovascular
  • Intracranial aneurysm
  • Ophthalmic
  • Suction decompression

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Fulkerson, D. H., Horner, T. C., Payner, T. D., Leipzig, T. J., Scott, J. A., Denardo, A. J., Redelman, K., & Goodman, J. M. (2009). Endovascular retrograde suction decompression as an adjunct to surgical treatment of ophthalmic aneurysms: Analysis of risks and clinical outcomes. Neurosurgery, 64(3 SUPPL.), ons107-ons111. https://doi.org/10.1227/01.NEU.0000330391.20750.71