Abstract Number ‐ 82: Central Retinal Artery Metallic Embolus After Ophthalmic Segment Internal Carotid Artery Aneurysm Flow‐diverter Embolization

Abstract

Introduction Flow‐diverting stents are effective devices in treating what would have previously been difficult to treat aneurysms such as wide‐necked, fusiform, blood blister, or giant aneurysms. Although generally safe, complications have been reported such as ischemia, in‐stent stenosis, and side branch occlusion, as well as device related complications such as stent migration and incomplete expansion. We present a case report of a patient who was incidentally found to have a reflective metallic embolus within the central retinal artery after two flow‐diverter stent embolization of the ipsilateral ophthalmic segment aneurysm. Methods Case report. Results A 44 year‐old female presented with incidental discovery of a 4mm paraopthalmic aneurysm. She underwent two flow‐diverter (Pipeline ©) embolizations with decreased although persistent filling of the aneurysm sac. After the second embolization procedure, the patient was referred to Opthalmology after incidental note of a small submillimeter reflective metallic embolus adjacent to the fovea seen on a screening Optometry exam upon workup for reader glasses. The patient was asymptomatic without visual complaints, blurriness, floaters, or change in vision. Conclusions We present a case of a tiny submillimeter reflective metallic embolus after flow‐diverter stent placement within the ipsilateral ophthalmic artery. This is the first report we are aware of describing such a complication after the use of flow‐diverter stent deployment. It is possible that the increased friction from two apposing stents could cause microfractures and subclinical emboli.