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Fig 5. A, Frontal projection radiograph of a patient sent to our institution for treatment of a pseudoaneurysm (arrow) in the cavernous segment of the left internal carotid artery resulting from transsphenoidal surgery. Packing material (arrowheads) and a speculum (small arrows) were left in place from surgery. B, Postoperative CTA with 3D volume rendering demonstrates a clip occluding the proximal left internal carotid artery (arrow). A patent radial artery bypass (arrowheads) has a proximal anastomosis site to the left internal carotid artery just proximal to the clip. C, A second view demonstrates that the bypass is patent through the craniotomy site. D, Intracranial view shows the distal clip (arrow) effectively trapping the cavernous carotid pseudoaneurysm. The bypass (single arrowheads) is intact through the intracranial course, and the distal anastomosis (double arrowheads) to the middle cerebral artery is intact.
