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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:1449-1452, August 2003
© 2003 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Massive Epistaxis Related to Petrous Carotid Artery Pseudoaneurysm After Radiation Therapy: Emergency Treatment with Covered Stent in Two Cases

Kai Ming Auyeung^a, Wai Man Lui^b, Lawrence C.K. Chow^c and Fu Luk Chan^a

^a Department of Radiology, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong
^b Department of Neurosurgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong
^c Division of Otorhinolaryngology, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong

Address reprint requests to Kai Ming Auyeung, FRCR, FRANZCR, FHKCR, FHKAM (Radiology), Department of Radiology, Queen Mary Hospital, 102 Pokfulam Rd, Hong Kong SAR

Summary: Two patients had acute left carotid rupture from radiation therapy-induced pseudoaneurysms, resulting in hemodynamic collapse. Because the patients were semicomatose and in shock, an immediate salvage procedure was needed. Location of the pseudoaneurysm at the skull base made surgical treatment less possible. Endovascular therapy was the treatment of choice. Preserving patency of the carotid artery was a desirable option. The successful use of a covered stent in the emergency treatment of massive epistaxis due to active bleeding from pseudoaneurysm in the petrous internal carotid artery (ICA) is described.