Direct Repair of Iatrogenic Internal Carotid Artery Injury During Endoscopic Endonasal Approach Surgery With Temporary Endovascular Balloon-Assisted Occlusion: Technical Case Report.
BACKGROUND
Iatrogenic internal carotid artery (ICA) injuries during endoscopic endonasal approach (EEA) surgeries are associated with a high morbidity and mortality, with few acceptable methods described for repair.


METHODS
A 13-year-old girl with a large anterior and central skull base osteoblastoma incurred an iatrogenic cavernous ICA injury during a staged EEA approach. Intraoperative angiogram was performed with balloon-assisted EEA primary microsurgical repair of the lacerated ICA.


CONCLUSIONS
By integrating current techniques commonly used in open aneurysm surgeries and in endovascular procedures, we developed a rapid, safe technique to repair an EEA-associated iatrogenic ICA injury.
*Duke University Hospitals, Department of Neurosurgery, Durham, North Carolina; ‡The Ohio State University Hospitals, Department of Neurosurgery, Columbus, Ohio; §Duke University Hospitals, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Durham, North Carolina.
Mary In-Ping Huang
MI
Cobb
Shahid
S
Nimjee
L Fernando
LF
Gonzalez
David Woojin
DW
Jang
Ali
A
Zomorodi
D000293:Adolescent; D017541:Aneurysm, False / Q000601:surgery; D021721:Balloon Occlusion / Q000379:methods*; D020212:Carotid Artery Injuries / Q000209:etiology* / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D002533:Cerebral Angiography; D004724:Endoscopy / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008866:Microsurgery / Q000379:methods; D016343:Monitoring, Intraoperative; D009296:Nasal Cavity / Q000601:surgery*; D018215:Osteoblastoma / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D019292:Skull Base Neoplasms / Q000601:surgery; D016896:Treatment Outcome