title: Successful treatment of iatrogenic vertebral pseudoaneurysm using pipeline embolization device.
abstract: Traumatic pseudoaneurysms are uncommon and one of the most difficult lesions to treat. Traditional treatment methods have focused on parent vessel sacrifice with or without revascularization. We report the case of a patient who underwent successful treatment of an iatrogenic extracranial vertebral artery pseudoaneurysm using the Pipeline Embolization Device. A 47-year-old man sustained an inadvertent injury to the left vertebral artery during C1-C2 fixation. Subsequent imaging revealed an iatrogenic vertebral artery pseudoaneurysm. Immediate angiogram was normal. A repeat angiogram done after 3 days of the surgery revealed a vertebral artery pseudoaneurysm. He underwent aneurysm exclusion and vascular reconstruction using the Pipeline Embolization Device. Although flow-diverting stents are currently not being used for treating traumatic pseudoaneurysms, their use may be considered in such cases if active bleeding has ceased. In our case, the patient did well and the aneurysm was excluded from circulation while reconstructing the vessel wall.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71103, USA.
authors.forename: Sudheer
authors.identifier: 0000-0001-5145-7172
authors.initials: S
authors.lastname: Ambekar
authors.affiliation: Center of Neuromodulation, Wexner Medical Center, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Mayur
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71103, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Smith
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71103, USA.
authors.forename: Hugo
authors.identifier: 0000-0002-8348-4535
authors.initials: H
authors.lastname: Cuellar