Preservation of the optic nerve during surgery for paraclinoid carotid artery aneurysm

Abstract

Recently, endovascular interventions such as coil embolization and flow-diverting stenting are usually used to manage paraclinoid carotid artery aneurysms due to anatomical location and visual complications. However, all paraclinoid carotid artery aneurysms cannot be treated with the endovascular approach. To prevent visual complications, clipping surgery for paraclinoid carotid artery aneurysm, skull base technique, retrograde suction decompression method, intraoperative electrophysiological monitoring, and indo-cyanine green videoangiography have been developed. In this report, the functional anatomies of the ophthalmic artery and the superior hypophyseal artery feeding the optic apparatus and originating from the paraclinoid carotid artery are summarized. Moreover, the direct surgical procedure used for paraclinoid carotid artery aneurysm is presented.