Repair of carotid artery perforations during transsphenoidal surgery.
BACKGROUND
Hemorrhage from carotid artery injury during transsphenoidal surgery is an unusual, but potentially fatal complication.


METHODS
Among six patients experiencing laceration or perforation of the carotid artery, we treated four with a new technique using Teflon mesh and methyl methacrylate to form an external, artificial wall over the laceration and the carotid artery.


RESULTS
In all four cases, hemorrhage was successfully controlled without neurologic deficit to the patient or complications frequently associated with the standard technique of nasal and sphenoid sinus packing removal.


CONCLUSIONS
Our new technique may be superior to packing alone, as well as potentially life-saving to the patient.
ANI Department of Neurosurgery, Allegheny General Hospital and The Medical College of Pennsylvania and Hahnemann University, Pittsburgh, USA.
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Fukushima
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JC
Maroon
D000236:Adenoma / Q000601:surgery; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D020212:Carotid Artery Injuries; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D010911:Pituitary Neoplasms / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery*