Retinal artery/arteriole occlusion risks after endovascular treatment for unruptured intracranial aneurysm  

作　　者：Hae Rang Kim Min Jeoung Kim Sunyeup Kim Myung Soo Chang Dong Joon Kim Byung Moon Kim Keun Young Park Yong Bae Kim Christopher Seungkyu Lee Suk Ho Byeon Sung Soo Kim Seung Won Lee Yong Joon Kim 

机构地区：[1]Department of Ophthalmology,CHA Bundang Medical Center,CHA University College of Medicine,Seongnam,Korea(the Republic of) [2]Department of Neurosurgery,Severance Stroke Center,Severance Hospital,Yonsei University College of Medicine,Seoul,Korea(the Republic of) [3]Department of Neurosurgery,Uijeongbu St.Mary’s Hospital,The Catholic University of Korea College of Medicine,Uijeongbu,Korea(the Republic of) [4]Department of Medical AI,Sungkyunkwan University School of Medicine,Suwon,Korea(the Republic of) [5]Department of Ophthalmology,Institute of Vision Research,Yonsei University College of Medicine,Seoul,Korea(the Republic of) [6]Department of Radiology,Severance Stroke Center,Severance Hospital,Yonsei University College of Medicine,Seoul,Korea(the Republic of) [7]Department of Precision Medicine,Sungkyunkwan University School of Medicine,Suwon,Korea(the Republic of)

出　　处：《Stroke & Vascular Neurology》2024年第3期295-305,I0251-I0263,共24页卒中与血管神经病学（英文）

基　　金：supported by Basic Science Research Program through the National Research Foundation(NRF)of Korea funded by the Ministry of Education(2022R1I1A1A01059209);supported by grants of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HI21C1705,HI22C0782).

摘　　要：Background To evaluate the association between retinal artery/arteriole occlusion(RAO)and unruptured intracranial aneurysm(UIA).Methods Incident UIA patients from a nationwide cohort(n=253240)were categorised into three groups based on subsequent treatment:observation(n=208993),microsurgical clipping(n=14168)and endovascular treatment(EVT)groups(n=30079).The incidence and the incident time of RAO were analysed.HRs of RAO and associated risk factors were evaluated.Additionally,a hospital cohort comprising 2569 consecutive UIA patients treated at a tertiary hospital was analysed with detailed clinical information of UIAs.Results In the nationwide cohort analysis,the incidence of RAO was significantly higher in EVT group than in observation and clipping groups,especially within 60 days(early RAO(within 60 days):HR=4.00,95%CI:2.44 to 6.56);delayed RAO(after 60 days:HR=1.74,95%CI:1.13 to 2.68).Multivariable analysis showed that the presence of chronic kidney disease(p=0.009)and use of a balloon microcatheter during the procedure(p=0.013)were associated with a higher risk of RAO.In hospital cohort analysis,11(0.8%)cases of RAO occurred after EVT,whereas none occurred after microsurgical clipping(p<0.001).Patients with RAO were younger and received balloon microcatheters more frequently than their counterparts.Ten cases of RAO(90.9%)occurred in paraclinoid aneurysms,where EVT was preferred over microsurgical clipping.Conclusions Performing EVT for UIA may increase the risk of subsequent RAO.Care should be taken when treating paraclinoid aneurysms with balloon microcatheters.

关 键 词：treatment NATIONWIDE BALLOON 

分 类 号：R741[医药卫生—神经病学与精神病学]