Treatment of iatrogenic internal carotid artery laceration and carotid cavernous fistula with endovascular stent-graft placement.
The risk of fatal injury of the internal carotid artery (ICA) and surrounding anatomy during transsphenoidal surgery for pituitary adenoma is the most severe potential complication associated with this particular approach. We present a case in which iatrogenic injury to a patient's ICA and resultant carotid cavernous fistula and massive hemorrhage was successfully managed with the emergency placement of an endovascular stent-graft. Both findings in the relevant literature and practical considerations concerning both stent-grafts and other more commonly used options for the treatment of iatrogenic ICA injury are discussed.
Kocer
Naci
N
Division of Neuroradiology, Department of Radiology, Cerrahpasa Medical School, Istanbul, Turkey.
Kizilkilic
Osman
O
Albayram
Sait
S
Adaletli
Ibrahim
I
Kantarci
Fatih
F
Islak
Civan
C
D000236:Adenoma / Q000601:surgery; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007016:Hypophysectomy / Q000009:adverse effects; D007049:Iatrogenic Disease; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000628:therapy*; D007431:Intraoperative Complications / Q000628:therapy*; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery; D011859:Radiography; D015607:Stents