J Cerebrovasc Endovasc Neurosurg.  2016 Dec;18(4):369-372. 10.7461/jcen.2016.18.4.369.

Intra-arterial Thrombolysis for Central Retinal Artery Occlusion after the Coil Embolization of Paraclinoid Aneurysm

• Yoo M
• Jin SC
• Kim HY
• Choi BS

• KMID: 2367328
• DOI: http://doi.org/10.7461/jcen.2016.18.4.369

Abstract

The most common complication of coil embolization for cerebral aneurysms is thrombo-embolic stroke; in rare cases, these strokes, can present with central retinal artery occlusion. At our institution, a 53-year-old woman underwent stent-assisted coiling of the aneurysm. The patient's vision was improved immediately after intra-arterial thrombolysis and had further improved 8 months later. This report describes our experience of a rare case of central retinal artery occlusion after coil embolization that was successfully treated by intra-arterial thrombolysis.

Keyword

Central retinal artery occlusion; Embolization; Thrombolysis; Paraclinoid aneurysm

MeSH Terms

Aneurysm*
Embolization, Therapeutic*
Female
Humans
Intracranial Aneurysm
Middle Aged
Retinal Artery Occlusion*
Retinal Artery*
Stroke

Figure

• 

  Fig. 1 Postcoiling angiogram demonstrates the complete obliteration of the aneurysm. (A) A lateral view and (B) a 3D reconstructed angiogram demonstrate the complete obliteration of the aneurysm with nine platinum coils. The ophthalmic artery (white arrows) and a contrast enhancement of the posterior eye bulb, a phenomenon known as -choroidal blush (black arrows) are visible immediately proximal to the aneurysm and remain patent in the post-embolization angiogram.

• 

  Fig. 2 After intra-arterial thrombolysis, the intensity of the choroidal blush is increased. (A) A left ICA angiogram (lateral view) before thrombolysis demonstrates the absence of the choroidal blush (white arrow). (B) A left ICA angiogram (lateral view) obtained after intra-arterial thrombolysis with 500,000 U of urokinase and 1,000 mcg of Aggrastat demonstrates an increase in the intensity of the choroidal blush (white arrow). ICA = internal carotid artery.

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