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Abstract：
BACKGROUND: Ophthalmic artery aneurysm (OAA) can be secured in endovascular or microsurgical approaches. Still there are controversies in technique selection and their long term outcomes.
METHODS: All the patients with OAA were treated microsurgically and followed. Demographic data, neurological status, physical examination findings, angiographic data, operation details, and intraoperative and postoperative events were recorded and analyzed. P < 0.05 was considered significant.
RESULTS: Among 55 patients, 38 were females (69.1%). Median preoperative glasgow coma scale (GCS), Fisher Grade, and Hunt and Hess(HH) scores were 15, 1 and 1, respectively. The most common neurologic manifestation was visual problems (n = 15). The most common anatomical projection was medial (43.6%) oriented lesions. 85.5% of them only had 1 ophthalmic aneurysm while multiple aneurysms were reported in 14.6%. In 52 patients temporary clip was used. in 21 patients (38.2%) intraoperative aneurysm rupture occurred. Larger aneurysm size and preoperative hydrocephalus were associated with higher rates of aneurysm rupture (P = 0.003 and 0.031). 28.5% of the patients with visual problems had clinical improvement in the postoperative period. The mean follow-up period was 5 years. Follow-up angiography showed a 100% obliteration rate with a 0.0% recurrence rate. Median values for follow-up glasgow outcome scale and modified Rankin scale were 5 and 0, respectively. favorable neurological outcomes were associated with better primary GCS and HH scores.
CONCLUSIONS: OAA microsurgery is an effective and safe procedure with significant improvement in both visual and neurological status. Low recurrence rate and excellent clinical recovery are the most important advantages of microsurgery in OAA treatment.
METHODS: All the patients with OAA were treated microsurgically and followed. Demographic data, neurological status, physical examination findings, angiographic data, operation details, and intraoperative and postoperative events were recorded and analyzed. P < 0.05 was considered significant.
RESULTS: Among 55 patients, 38 were females (69.1%). Median preoperative glasgow coma scale (GCS), Fisher Grade, and Hunt and Hess(HH) scores were 15, 1 and 1, respectively. The most common neurologic manifestation was visual problems (n = 15). The most common anatomical projection was medial (43.6%) oriented lesions. 85.5% of them only had 1 ophthalmic aneurysm while multiple aneurysms were reported in 14.6%. In 52 patients temporary clip was used. in 21 patients (38.2%) intraoperative aneurysm rupture occurred. Larger aneurysm size and preoperative hydrocephalus were associated with higher rates of aneurysm rupture (P = 0.003 and 0.031). 28.5% of the patients with visual problems had clinical improvement in the postoperative period. The mean follow-up period was 5 years. Follow-up angiography showed a 100% obliteration rate with a 0.0% recurrence rate. Median values for follow-up glasgow outcome scale and modified Rankin scale were 5 and 0, respectively. favorable neurological outcomes were associated with better primary GCS and HH scores.
CONCLUSIONS: OAA microsurgery is an effective and safe procedure with significant improvement in both visual and neurological status. Low recurrence rate and excellent clinical recovery are the most important advantages of microsurgery in OAA treatment.
摘要：
背景：眼动脉瘤（OAA）可以通过血管内或显微外科方法进行固定。在技术选择及其长期结果方面仍然存在争议。
方法：所有OAA患者均行显微手术治疗。人口统计数据,神经状况,体检结果,血管造影数据，操作详细信息,记录和分析术中及术后事件。P<0.05被认为是显著的。
结果：在55名患者中，女性38人（69.1%）。术前格拉斯哥昏迷评分中位数（GCS），费舍尔等级,Hunt和Hess(HH)评分分别为15分、1分和1分。最常见的神经系统表现是视觉问题（n=15）。最常见的解剖投影是内侧（43.6％）定向的病变。其中85.5％的患者仅有1个眼动脉瘤，而14.6％的患者报告有多发动脉瘤。在52例患者中，使用了临时夹子。21例患者（38.2%）术中发生动脉瘤破裂。较大的动脉瘤大小和术前脑积水与较高的动脉瘤破裂率相关(P=0.003和0.031)。有视觉问题的患者中，有28.5％的患者在术后有临床改善。平均随访期为5年。随访血管造影显示闭塞率100％，复发率为0.0％。随访格拉斯哥结果量表和改良Rankin量表的中位数分别为5和0。良好的神经系统结局与较好的原发性GCS和HH评分相关.
结论：OAA显微手术是一种有效且安全的手术，视觉和神经状态都有显著改善。低复发率和良好的临床恢复是显微手术在OAA治疗中最重要的优势。
方法：所有OAA患者均行显微手术治疗。人口统计数据,神经状况,体检结果,血管造影数据，操作详细信息,记录和分析术中及术后事件。P<0.05被认为是显著的。
结果：在55名患者中，女性38人（69.1%）。术前格拉斯哥昏迷评分中位数（GCS），费舍尔等级,Hunt和Hess(HH)评分分别为15分、1分和1分。最常见的神经系统表现是视觉问题（n=15）。最常见的解剖投影是内侧（43.6％）定向的病变。其中85.5％的患者仅有1个眼动脉瘤，而14.6％的患者报告有多发动脉瘤。在52例患者中，使用了临时夹子。21例患者（38.2%）术中发生动脉瘤破裂。较大的动脉瘤大小和术前脑积水与较高的动脉瘤破裂率相关(P=0.003和0.031)。有视觉问题的患者中，有28.5％的患者在术后有临床改善。平均随访期为5年。随访血管造影显示闭塞率100％，复发率为0.0％。随访格拉斯哥结果量表和改良Rankin量表的中位数分别为5和0。良好的神经系统结局与较好的原发性GCS和HH评分相关.
结论：OAA显微手术是一种有效且安全的手术，视觉和神经状态都有显著改善。低复发率和良好的临床恢复是显微手术在OAA治疗中最重要的优势。
