A Case of Pseudoaneurysm of the Internal Carotid Artery Following Endoscopic Endonasal Pituitary Surgery: Endovascular Treatment with Flow-Diverting Stent Implantation

Karadag, Ali; Kinali, Burak; Ugur, Omer; Oran, Ismail; Middlebrooks, Erik H.; Senoglu, Mehmet

doi:10.14712/18059694.2017.100

Acta Medica > Archive > 2017, Vol. 60 > Issue 2 > A Case of Pseudoaneurysm of the Internal…

Acta Med. 2017, 60: 89-92

https://doi.org/10.14712/18059694.2017.100

A Case of Pseudoaneurysm of the Internal Carotid Artery Following Endoscopic Endonasal Pituitary Surgery: Endovascular Treatment with Flow-Diverting Stent Implantation

Ali Karadag^a, Burak Kinali^a, Omer Ugur^b, Ismail Oran^c, Erik H. Middlebrooks^d, Mehmet Senoglu^a

^aDepartment of Neurosurgery, Saglik Bilimleri University, Tepecik Research and Training Hospital, Izmir, Turkey
^bDepartment of Otolaryngology, Saglik Bilimleri University, Tepecik Research and Training Hospital, Izmir, Turkey
^cEge University Faculty of Medicine, Department of Radiology, Izmir, Turkey
^dDepartment of Radiology, University of Alabama at Birmingham, Alabama, USA

Received November 5, 2016
Accepted April 28, 2017

Internal carotid artery (ICA) pseudoaneurysm is a rare complication of endoscopic endonasal surgery occurring in 0.4–1.1% of cases. Pseudoaneurysms can subsequently result in other complications, such as subarachnoid hemorrhage, epistaxis, and caroticocavernous fistula with resultant death or permanent neurologic deficit. In this case, we illustrate endovascular treatment with a flow-diverting stent for an ICA pseudoaneurysm after endoscopic endonasal surgery for a pituitary adenoma in a 56-year-old male. Surgery was complicated by excessive intraoperative bleeding and emergent CT angiography confirmed an iatrogenic pseudoaneurysm on the anteromedial surface of the ICA. The pseudoaneurysm was treated endovascularly with flow-diverting stent implantation only. Follow-up CT angiography after three months demonstrated occlusion of the pseudoaneurysm.