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Emergency endovascular stent graft and coil placement for internal carotid artery injury during transsphenoidal surgery

Authors
 Young Seok Park  ;  Jin Young Jung  ;  Jung Yong Ahn  ;  Dong Jun Kim  ;  Sun Ho Kim 
Citation
 SURGICAL NEUROLOGY , Vol.72(6) : 741-746, 2009 
Journal Title
 SURGICAL NEUROLOGY 
ISSN
 0090-3019 
Issue Date
2009
Keywords
Internal carotid artery injuries ; Endovascular treatments ; Stent grafts ; Coils ; Transsphenoidal approach
Abstract
BACKGROUND: An internal carotid artery (ICA) injury is an uncommon but potentially fatal complication of transsphenoidal surgery. CASE DESCRIPTION: We report a 61-year-old male patient with a right cavernous ICA injury sustained during transsphenoidal surgery and who underwent endovascular Stent graft placement. The ICA trapping was not indicated because of the absence of the left A1 on preoperative magnetic resonance angiography. During Stent graft placement, the ICA wall could not be completely fit with a stent due to its stiff nature and the carotid curve. The gap between the stent and the ICA wall was filled using a coiling procedure on the first postoperative day. CONCLUSIONS: Endovascular Stent graft placement for posttranssphenoidal carotid artery injury is a useful technical adjunct to the management strategy and has the potential to minimize the risk of having to sacrifice the ICA. In cases of incomplete reconstruction of the Stent graft placement due to its stiff nature and the carotid curve, an additional coiling procedure could be helpful to obliterate the gap between the stent and the ICA wall. To avoid carotid injury during transsphenoidal surgery, careful preoperative evaluation of vascular structures and meticulous surgical technique are necessary.
Full Text
http://www.sciencedirect.com/science/article/pii/S0090301909004364
DOI
10.1016/j.surneu.2009.05.003
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Park, Young Seok(박영석)
Ahn, Jung Yong(안정용)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105770
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