Embolisation of branches of the ophthalmic artery

Nine patients presenting various orbital and skull base pathologies embolised through the ophthalmic artery are reported. All cases were catheterised beyond the bend around the optic nerve (second portion of the intraorbital ophthalmic artery). Embolisation was carried in all with n-butyl cyano-acrylate without post interventional visual disturbance. Relying on the classic description as well as previous personal work on the ophthalmic artery anatomy and angiographic anatomy, all procedures were performed under general anaesthesia without functional testing. The central retinal artery and the long ciliary arteries arise from the first or second portion of the ophthalmic artery. For embryological reasons no branch to the visual tract can arise from the ophthalmic trunk distal to the origin of the superficial recurrent meningeal artery or the lacrimal artery. Therefore distal catheterisation at least beyond the second portion, (and injection without reflux) makes safe embolisation possible in all variations of internal carotid origin of the ophthalmic stem. Independent from the expected goal of the embolisation, the use of particles in this territory should in our opinion be discouraged.