Rupture from cavernous internal carotid artery pseudoaneurysm 11 years after transsphenoidal surgery. (September 2020)

• Record Type: Journal Article
• Authors: Morrison, Thomas; Jukes, Alistair; Wong, Johnny
• Is Part Of: Journal of clinical neuroscience. Volume 79(2020)
• Page Start: 266
• Page End: 268
• Publication Date: 2020-09
• Subjects: Pseudoaneurysm -- Endovascular treatment -- Transsphenoidal surgery -- Flow diversion; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.06.018
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Pseudoaneurysm formation can occur more than a decade after transsphenoidal surgery. Psuedoaneurysm rupture should be considered with epistaxis regardless of time course. Endovascular treatment options include combination coiling and flow-diversion stent placement. Abstract: Carotid artery pseudoaneurysm is a rare complication of transsphenoidal surgery, usually diagnosed within 90 days post procedure. Sequelae of pseudoaneurysm rupture, such as severe epistaxis or carotid cavernous fistula (CCF), have significant morbidity and mortality. A case of epistaxis from pseudoaneurysm rupture over a decade after transsphenoidal surgery is presented, with staged treatment using coiling, endonasal mucosal flap repair and interval flow-diverting stent insertion. This case illustrates that pseudoaneurysm rupture occurs regardless of time course after transsphenoidal surgery, and treatment strategies using combined endovascular and endonasal techniques are reviewed.