Treatment of ruptured ICA during transsphenoidal surgery. Two different endovascular strategies in two cases.
Rupture of the internal carotid artery (ICA) during transsphenoidal surgery is a rare but potentially lethal complication. Direct surgical repair of the ICA may be difficult and time-consuming in an acute setting. Urgent endovascular treatments with vascular plug or stent-graft have been the feasible options to date. We desrcibe two cases of iatrogenic rupture of ICA during transsphenoidal surgery. In the first case we occluded the ICA with a vascular plug at the site of tear where cross circulation was adequate. In the second case we had to preserve the ICA with stent-graft since there was no adequate cross circulation. These two strategies are discussed below.
Ghatge
S B
SB
Department of Interventional Neuroradiology, Bombay Hospital; Mumbai, India. drsharadghatge@yahoo.com
Modi
D B
DB
D000328:Adult; D001807:Blood Vessel Prosthesis; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012421:Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery*; D015607:Stents; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods