Embolization of Neurosurgical Lesions Involving the Ophthalmic Artery

Embolization of Neurosurgical Lesions Involving the Ophthalmic Artery AbstractOBJECTIVE:A number of anteriorly located cranial base and extracranial lesions receive their vascular supply wholly or in part from the ophthalmic artery, and embolization of the ophthalmic artery can be helpful in the management of these lesions, either as the primary treatment or as an adjunct to surgery. We present situations in which the embolization of lesions involving the ophthalmic artery was performed to effect a partial or total cure of the lesion.METHODS:Twelve patients underwent a total of 15 embolization attempts on lesions involving the ophthalmic artery. Four patients had arteriovenous malformations of the orbit, four had dural arteriovenous fistulae, two had orbital meningiomas, one had a planum sphenoidale meningioma, and one had a juvenile nasal angiofibroma. In each case, a Tracker No. 18 microcatheter (Target Therapeutics, Inc., Fremont, CA) was navigated into the ophthalmic artery using a steerable guidewire and digital road mapping. Embolic agents included polyvinyl alcohol particles ranging from 350 to 1500 fxm in diameter, 2-mm platinum microcoils, and n-butylcyanoacrylate. In 12 of 15 cases, lidocaine and aniytal provocation tests were conducted before any attempt at embolization to assess the role of the ophthalmic artery in vision.RESULTS:Embolization was successfully performed in the 14 situations in which it was attempted. Positive results of two lidocaine/amytal tests were noted. In one case, embolization was not attempted. In the other case, a larger caliber embolic agent (2-mm platinum coils) was used. A single transient decrease in visual acuity lasting 4 days was the only embolization-related complication.CONCLUSION:Proper case selection, judicious use of embolic agents, and use of provocative testing can result in safe embolization of lesions supplied by the ophthalmic artery. (Neurosurgery 43:1298-1303, 1998) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Embolization of Neurosurgical Lesions Involving the Ophthalmic Artery

C L IN IC A L ST U D IE S Embolization of Neurosurgical Lesions Involving the Ophthalm ic Artery Michael Lefkowitz, M.D., Steven L. Giannotta, M.D., Grant Hieshima, M.D., Randall Higashida, M.D., Van Halbach, M.D., Christopher Dowd, M.D., George P. Teitelbaum, M.D. Departm ent of N e u ro lo g ic a l Surgery ( S C , G P T ), U n iv e rsity of Southern C a lifo rn ia Sch o o l of M e d icin e , Los A n g e le s; Departm ent of R a d io lo g y ( G H , R H , V H , C D ) , U n iversity of C a lifo rn ia at San F ra n cisco , San F ra n cisco ; and D epartm ent of R a d io lo g ic a l S cie n ce s (ML), E n d o v a scu la r T h e ra p y Se rvice , U n ive rsity of C a lifo rn ia , Los A n gele s, Los A n gele s, C a lifo rn ia OBJECTIVE: A n um be r o f a n te rio rly located cranial base and extracranial lesions receive th e ir vascular supply wholly or in part fro m the o p h th a lm ic artery, and e m b o liz a tio n o f the o p h th a lm ic a rte ry can be h elpful in the management of these lesions, e ither as the p rim a ry tre a tm e n t o r as an a d ju n ct to surgery. W e present situations in which the e m b o liza tio n o f lesions in v o lv in g the o p h th a lm ic a rte ry was p e rfo rm e d to effect a p a rtia l o r to ta l cure o f the lesion. M E T H O D S : T w e lv e p a tie n ts u n d e rw e n t a to ta l o f 15 e m b o liz a tio n a tte m p ts on lesions in v o lv in g th e ophthalmic a rte ry . Four p a tie n ts had a rte rio v e n o u s m a lfo rm a tio n s o f the o r b it, fo u r had d u ra l a rte rio v e n o u s fistulae, tw o had o r b ita l m e n in g io m a s, one had a p la n u m sp h e n o id a le m e n in g io m a , and one had a ju v e n ile nasal angiofibrom a. In each case, a T ra c k e r N o. 18 m ic ro c a th e te r (Target T h e ra p e u tics, Inc., F re m o n t, C A) was navigated into the o p h th a lm ic a rte ry using a steerable g u id e w ire and d ig ita l road m a p p in g . E m b o lic agents in c lu d e d polyvinyl a...
Loading next page...
 
/lp/ou_press/embolization-of-neurosurgical-lesions-involving-the-ophthalmic-artery-ovyjdiuURn
Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199812000-00016
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:A number of anteriorly located cranial base and extracranial lesions receive their vascular supply wholly or in part from the ophthalmic artery, and embolization of the ophthalmic artery can be helpful in the management of these lesions, either as the primary treatment or as an adjunct to surgery. We present situations in which the embolization of lesions involving the ophthalmic artery was performed to effect a partial or total cure of the lesion.METHODS:Twelve patients underwent a total of 15 embolization attempts on lesions involving the ophthalmic artery. Four patients had arteriovenous malformations of the orbit, four had dural arteriovenous fistulae, two had orbital meningiomas, one had a planum sphenoidale meningioma, and one had a juvenile nasal angiofibroma. In each case, a Tracker No. 18 microcatheter (Target Therapeutics, Inc., Fremont, CA) was navigated into the ophthalmic artery using a steerable guidewire and digital road mapping. Embolic agents included polyvinyl alcohol particles ranging from 350 to 1500 fxm in diameter, 2-mm platinum microcoils, and n-butylcyanoacrylate. In 12 of 15 cases, lidocaine and aniytal provocation tests were conducted before any attempt at embolization to assess the role of the ophthalmic artery in vision.RESULTS:Embolization was successfully performed in the 14 situations in which it was attempted. Positive results of two lidocaine/amytal tests were noted. In one case, embolization was not attempted. In the other case, a larger caliber embolic agent (2-mm platinum coils) was used. A single transient decrease in visual acuity lasting 4 days was the only embolization-related complication.CONCLUSION:Proper case selection, judicious use of embolic agents, and use of provocative testing can result in safe embolization of lesions supplied by the ophthalmic artery. (Neurosurgery 43:1298-1303, 1998)

Journal

NeurosurgeryOxford University Press

Published: Dec 1, 1998

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial