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 Karadaga, Burak Kinalia, Omer Ugurb, Ismail Oranc, Erik H. Middlebrooksd, Mehmet Senoglua

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.

References

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