Endovascular treatment of an internal carotid artery pseudoaneurysm following transsphenoidal surgery. Case report

Nurdin A. Kadyrov, Jonathan A. Friedman, Douglas A. Nichols, Aaron A. Cohen-Gadol, Michael J. Link, David G. Piepgras

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Internal carotid artery (ICA) pseudoaneurysm formation following transsphenoidal surgery is a rare but potentially lethal complication. Direct surgical repair with preservation of the ICA may be difficult. The feasibility of endovascular coil embolization with parent artery preservation for an iatrogenic ICA pseudoaneurysm is undefined. A 40-year old man was referred to the authors' institution after identification of a pseudoaneurysm of the left ICA following transsphenoidal resection of a pituitary macroadenoma. The pseudoaneurysm was treated via an endovascular approach that included stent-assisted coil embolization of the lesion. Follow-up angiographic studies obtained 1 year later demonstrated complete occlusion of the aneurysm, and the patient remains asymptomatic. Stent-assisted coil embolization of this iatrogenic pseudoaneurysm was successful in achieving complete, angiographically confirmed aneurysm obliteration, with preservation of the ICA and short-term prevention of hemorrhage or carotid-cavernous fistula. The endovascular method provided an effective, relatively low-risk treatment for this difficult lesion, and was an excellent alternative to direct surgical repair. Nonetheless, long-term follow-up review is required before definitive treatment recommendations can be made.

Original languageEnglish (US)
Pages (from-to)624-627
Number of pages4
JournalJournal of neurosurgery
Volume96
Issue number3
DOIs
StatePublished - Jan 1 2002

Keywords

  • Coil embolization
  • Endovascular therapy
  • Pseudoaneurysm
  • Stent
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Kadyrov, N. A., Friedman, J. A., Nichols, D. A., Cohen-Gadol, A. A., Link, M. J., & Piepgras, D. G. (2002). Endovascular treatment of an internal carotid artery pseudoaneurysm following transsphenoidal surgery. Case report. Journal of neurosurgery, 96(3), 624-627. https://doi.org/10.3171/jns.2002.96.3.0624