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Surgical treatment of a ruptured internal carotid artery pseudoaneurysm following transsphenoidal surgery

Journal of Cerebrovascular and Endovascular Neurosurgery / Journal of Cerebrovascular and Endovascular Neurosurgery, (P)2234-8565; (E)2287-3139
2022, v.24 no.4, pp.380-385
Luis Alfonso Castillejo Adalid (Specialties Hospital, 21st Century National Medical Center, Mexico City, Mexico)
Víctor Chávez Herrera (Specialties Hospital, 21st Century National Medical Center, Mexico City, Mexico)
Diego Soto Rubio (Specialties Hospital, 21st Century National Medical Center, Mexico City, Mexico)
Miguel Abdo Toro (Specialties Hospital, 21st Century National Medical Center, Mexico City, Mexico)
Eric Estrada Estrada (Specialties Hospital, 21st Century National Medical Center, Mexico City, Mexico)
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Abstract

Development of Internal Carotid Artery pseudoaneurysms (ICAp) after transsphenoidal surgery is extremely rare, occurring only in 0.4% of cases. Surgical treatment of ICAp poses a real challenge to the neurosurgeon as treatment may require parent vessel sacrifice or artery reconstruction with bypass grafting. Furthermore, surgical resolution of these lesions is rarely reported in the literature. The internal carotid artery is prone to iatrogenic injury in transsphenoidal surgery due to its frequent involvement in pituitary adenomas. Intracranial pseudoaneurysms may be at high risk for rupture and increased morbidity and mortality. Here we present a case of a patient with an ICAp rupture two months after transsphenoidal surgery for a pituitary adenoma.

keywords
Pseudoaneurysm, Carotid, Clipping, Artery, Pituitary, Adenoma

Journal of Cerebrovascular and Endovascular Neurosurgery