{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T07:40:08Z","timestamp":1750405208740,"version":"3.41.0"},"reference-count":14,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nVisual field defect and visual impairment are important but poorly characterized complications after flow-diverter (FD) stent placement for internal carotid artery (ICA) aneurysms.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nWe retrospectively analyzed 31 consecutive patients with 32 ICA aneurysms treated by FD stent implantation between October 2015 and April 2021. Aneurysms were classified into two groups those with visual symptoms before and after FD stenting (symptomatic group) and those without (asymptomatic group). We analyzed patients\u2019 background characteristics, treatment details, and imaging findings.<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nVisual symptoms were present in 25% (8\/32) of aneurysms and worsened after treatment in 9.4% (3\/32). Aneurysm enlargement was more common in the symptomatic group than the asymptomatic group (50% vs. 4.1%; odds ratio 23.0, 95% confidence interval [CI] 2.0\u2013262.6, P<\/jats:italic> = 0.0086). Poor visualization of the ophthalmic artery after procedure was observed in 50% versus 12.5% (odds ratio 7.0, 95% confidence interval 1.1\u201344.1, P<\/jats:italic> = 0.047). No central retinal artery occlusion or cerebral ischemic events were observed. All three deteriorating cases improved after high dose steroids: one required additional FD stenting.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nIn this single-center retrospective cohort, visual symptoms after FD stenting were relatively common but were usually reversible. Aneurysm enlargement and early loss of ophthalmic-artery flow identify patients at higher visual risk. Early steroid therapy and, when necessary, further endovascular treatment may mitigate visual deterioration.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_306_2025","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T07:11:54Z","timestamp":1750403514000},"page":"250","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Visual symptoms after flow-diverter stenting of internal carotid artery aneurysms: A retrospective cohort study"],"prefix":"10.25259","volume":"16","author":[{"given":"Yuko","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Stroke Medicine and Endovascular Therapy, University of Occupational and Environmental Health, Kitakyushu City, Japan"},{"name":"Department of Neurological Surgery, Showa Medical University, Fujigaoka Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshikazu","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Showa Medical University, Shinagawa City, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Tsumoto","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Showa Medical University, Fujigaoka Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Terada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Showa Medical University, Northern Yokohama Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"10.25259\/SNI_306_2025\/ref-1","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.3174\/ajnr.A3999","article-title":"Endovascular treatment of ophthalmic artery aneurysms: Assessing balloon test occlusion and preservation of vision in coil embolization","volume":"35","author":"Ahn","year":"2014","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_306_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.3174\/ajnr.A4175","article-title":"Mechanisms of healing in coiled intracranial aneurysms: A review of the literature","volume":"36","author":"Brinjikji","year":"2015","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_306_2025\/ref-3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.neurad.2018.07.006","article-title":"Patency of the supraclinoid internal carotid artery branches after flow diversion treatment. A meta-analysis","volume":"46","author":"Cagnazzo","year":"2019","journal-title":"J Neuroradiol"},{"key":"10.25259\/SNI_306_2025\/ref-4","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1136\/neurintsurg-2016-012730","article-title":"Quantitative flow measurement after placing a flow diverter for a distal internal carotid artery aneurysm","volume":"9","author":"Chen","year":"2017","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_306_2025\/ref-5","doi-asserted-by":"crossref","first-page":"837","DOI":"10.3171\/jns.2002.96.5.0837","article-title":"Postprocedure ischemic events after treatment of intracranial aneurysms with Guglielmi detachable coils","volume":"96","author":"Derdeyn","year":"2002","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_306_2025\/ref-6","doi-asserted-by":"crossref","first-page":"499","DOI":"10.4103\/ajns.AJNS_294_18","article-title":"Treatment outcomes of cerebral aneurysms presenting with optic neuropathy: A retrospective case 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artery after flow diversion treatment of paraclinoid aneurysms","volume":"116","author":"Puffer","year":"2012","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_306_2025\/ref-10","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.3171\/2017.3.FOCUS1718","article-title":"Vision outcomes in patients with paraclinoid aneurysms treated with clipping, coiling, or flow diversion: A systematic review and meta-analysis","volume":"42","author":"Silva","year":"2017","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_306_2025\/ref-11","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.3174\/ajnr.A0550","article-title":"Severe inflammatory reaction of the optic system after endovascular treatment of a supraophthalmic aneurysm with bioactive coils","volume":"28","author":"Stracke","year":"2007","journal-title":"AJNR Am J 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