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Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm

Direct surgery for paraclinoid aneurysms can result in visual field deficit owing to compromised blood flow to the superior hypophyseal artery (SHA). However, it is rarely visualized in angiography, and discussions regarding its preservation in the field of neuro-endovascular treatment are limited....

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Autores principales: Otawa, Masato, Izumi, Takashi, Nishihori, Masahiro, Tsukada, Tetsuya, Oshima, Ryosuke, Kawaguchi, Tomomi, Goto, Shunsaku, Ikezawa, Mizuka, Kropp, Asuka Elisabeth, Araki, Yoshio, Uda, Kenji, Wakabayashi, Toshihiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nagoya University 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938102/
https://www.ncbi.nlm.nih.gov/pubmed/33727734
http://dx.doi.org/10.18999/nagjms.83.1.21
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author Otawa, Masato
Izumi, Takashi
Nishihori, Masahiro
Tsukada, Tetsuya
Oshima, Ryosuke
Kawaguchi, Tomomi
Goto, Shunsaku
Ikezawa, Mizuka
Kropp, Asuka Elisabeth
Araki, Yoshio
Uda, Kenji
Wakabayashi, Toshihiko
author_facet Otawa, Masato
Izumi, Takashi
Nishihori, Masahiro
Tsukada, Tetsuya
Oshima, Ryosuke
Kawaguchi, Tomomi
Goto, Shunsaku
Ikezawa, Mizuka
Kropp, Asuka Elisabeth
Araki, Yoshio
Uda, Kenji
Wakabayashi, Toshihiko
author_sort Otawa, Masato
collection PubMed
description Direct surgery for paraclinoid aneurysms can result in visual field deficit owing to compromised blood flow to the superior hypophyseal artery (SHA). However, it is rarely visualized in angiography, and discussions regarding its preservation in the field of neuro-endovascular treatment are limited. Biplane angiographic suite with high spatial resolution has been used at our institution since 2014. Since then, there were a few cases where SHAs could be visualized via digital subtraction angiography. We retrospectively analyzed the relationship between the presences and abscence of SHAs in paraclinoid aneurysms and post-procedural visual field deficit. Sixty-three paraclinoid aneuryms treated by neuro-endovascular procedure in 2014–2018 at our neurosurgery department were analyzed. Pre- and post-procedural multiplanar reconstruction imagings of three-dimensional rotation angiography were analyzed to retrospectively investigate the SHAs. SHAs were visualized in 26 patients (41%) and the median number of pre-procedurally visualized SHAs was 0 (interquartile range 0–1). Their origins were the aneurysmal necks in 11 patients (42%). In two of the 11 cases, they were noticed before coil embolization and were able to be preserved after the procedure. In the remaining nine cases, they were not pre-procedurally detected, and coiling was normally conducted. Visual field deficit occurred in one of these nine cases, but symptoms were transient, and the patient fully recovered. Because SHAs could be visualized in >40% cases and no visual field defects occurred in cases that SHAs could be identified and preserved preoperatively, we recommend their preservation during coil embolization for paraclinoid aneurysms.
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spelling pubmed-79381022021-03-15 Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm Otawa, Masato Izumi, Takashi Nishihori, Masahiro Tsukada, Tetsuya Oshima, Ryosuke Kawaguchi, Tomomi Goto, Shunsaku Ikezawa, Mizuka Kropp, Asuka Elisabeth Araki, Yoshio Uda, Kenji Wakabayashi, Toshihiko Nagoya J Med Sci Original Paper Direct surgery for paraclinoid aneurysms can result in visual field deficit owing to compromised blood flow to the superior hypophyseal artery (SHA). However, it is rarely visualized in angiography, and discussions regarding its preservation in the field of neuro-endovascular treatment are limited. Biplane angiographic suite with high spatial resolution has been used at our institution since 2014. Since then, there were a few cases where SHAs could be visualized via digital subtraction angiography. We retrospectively analyzed the relationship between the presences and abscence of SHAs in paraclinoid aneurysms and post-procedural visual field deficit. Sixty-three paraclinoid aneuryms treated by neuro-endovascular procedure in 2014–2018 at our neurosurgery department were analyzed. Pre- and post-procedural multiplanar reconstruction imagings of three-dimensional rotation angiography were analyzed to retrospectively investigate the SHAs. SHAs were visualized in 26 patients (41%) and the median number of pre-procedurally visualized SHAs was 0 (interquartile range 0–1). Their origins were the aneurysmal necks in 11 patients (42%). In two of the 11 cases, they were noticed before coil embolization and were able to be preserved after the procedure. In the remaining nine cases, they were not pre-procedurally detected, and coiling was normally conducted. Visual field deficit occurred in one of these nine cases, but symptoms were transient, and the patient fully recovered. Because SHAs could be visualized in >40% cases and no visual field defects occurred in cases that SHAs could be identified and preserved preoperatively, we recommend their preservation during coil embolization for paraclinoid aneurysms. Nagoya University 2021-02 /pmc/articles/PMC7938102/ /pubmed/33727734 http://dx.doi.org/10.18999/nagjms.83.1.21 Text en http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Otawa, Masato
Izumi, Takashi
Nishihori, Masahiro
Tsukada, Tetsuya
Oshima, Ryosuke
Kawaguchi, Tomomi
Goto, Shunsaku
Ikezawa, Mizuka
Kropp, Asuka Elisabeth
Araki, Yoshio
Uda, Kenji
Wakabayashi, Toshihiko
Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
title Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
title_full Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
title_fullStr Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
title_full_unstemmed Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
title_short Analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
title_sort analysis of relationship between superior hypophyseal artery visualization and preservation and postoperative visual field deficit in paraclinoid aneurysm
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938102/
https://www.ncbi.nlm.nih.gov/pubmed/33727734
http://dx.doi.org/10.18999/nagjms.83.1.21
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