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

J Neurosurg. 2002 Mar;96(3):624-7. doi: 10.3171/jns.2002.96.3.0624.

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 carotidcavernous 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.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / surgery*
  • Adult
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / therapy*
  • Carotid Artery Injuries / diagnostic imaging
  • Carotid Artery Injuries / therapy*
  • Carotid Artery, Internal, Dissection / diagnostic imaging
  • Carotid Artery, Internal, Dissection / therapy*
  • Cerebral Angiography
  • Embolization, Therapeutic*
  • Humans
  • Iatrogenic Disease
  • Male
  • Pituitary Neoplasms / surgery*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / therapy*
  • Sphenoid Sinus / surgery
  • Stents*