Cargando…
Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase
Internal carotid artery (ICA) injury is a catastrophic complication of endoscopic endonasal surgery (EES). However, its standard management, emergent endovascular treatment, may not always be available, and the transnasal approach may be insufficient to achieve hemostasis. A 44-year-old woman with p...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2021
|
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670996/ https://www.ncbi.nlm.nih.gov/pubmed/34917447 http://dx.doi.org/10.1055/s-0041-1740511 |
_version_ | 1784615074537668608 |
---|---|
author | Kahilogullari, Gokmen Bahadır, Burak Bozkurt, Melih Akcalar, Seray Balci, Sinan Arat, Anil |
author_facet | Kahilogullari, Gokmen Bahadır, Burak Bozkurt, Melih Akcalar, Seray Balci, Sinan Arat, Anil |
author_sort | Kahilogullari, Gokmen |
collection | PubMed |
description | Internal carotid artery (ICA) injury is a catastrophic complication of endoscopic endonasal surgery (EES). However, its standard management, emergent endovascular treatment, may not always be available, and the transnasal approach may be insufficient to achieve hemostasis. A 44-year-old woman with pituitary adenoma underwent EES complicated with the ICA cavernous segment injury (CSI). In urgent intraoperative angiogram, a good collateral flow from the contralateral carotid circulation was observed. Due to the unavailability of intraoperative embolization, emergent surgical trapping was performed by combined transcranial and cervical approach. The patient recovered but later developed a giant cavernous pseudoaneurysm. During the pseudoaneurysm embolization, ICA was directly accessed via a 1.7-F puncture hole using a bare microcatheter technique. Then, both the aneurysm and parent artery were obliterated with coils. At the 4-year follow-up, the patient was asymptomatic without a residual tumor. To our knowledge, this is the first case of ICA–CSI during EES successfully treated with ICA trapping as a lifesaving urgent surgery that achieved a complete recovery after a pseudoaneurysm embolization. Although several studies reported that EES-related ICA–CSIs with percutaneous carotid artery access, neither our surgical salvage technique nor our carotid access and tract embolization techniques were previously described. |
format | Online Article Text |
id | pubmed-8670996 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-86709962021-12-15 Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase Kahilogullari, Gokmen Bahadır, Burak Bozkurt, Melih Akcalar, Seray Balci, Sinan Arat, Anil J Neurol Surg Rep Internal carotid artery (ICA) injury is a catastrophic complication of endoscopic endonasal surgery (EES). However, its standard management, emergent endovascular treatment, may not always be available, and the transnasal approach may be insufficient to achieve hemostasis. A 44-year-old woman with pituitary adenoma underwent EES complicated with the ICA cavernous segment injury (CSI). In urgent intraoperative angiogram, a good collateral flow from the contralateral carotid circulation was observed. Due to the unavailability of intraoperative embolization, emergent surgical trapping was performed by combined transcranial and cervical approach. The patient recovered but later developed a giant cavernous pseudoaneurysm. During the pseudoaneurysm embolization, ICA was directly accessed via a 1.7-F puncture hole using a bare microcatheter technique. Then, both the aneurysm and parent artery were obliterated with coils. At the 4-year follow-up, the patient was asymptomatic without a residual tumor. To our knowledge, this is the first case of ICA–CSI during EES successfully treated with ICA trapping as a lifesaving urgent surgery that achieved a complete recovery after a pseudoaneurysm embolization. Although several studies reported that EES-related ICA–CSIs with percutaneous carotid artery access, neither our surgical salvage technique nor our carotid access and tract embolization techniques were previously described. Georg Thieme Verlag KG 2021-12-14 /pmc/articles/PMC8670996/ /pubmed/34917447 http://dx.doi.org/10.1055/s-0041-1740511 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Kahilogullari, Gokmen Bahadır, Burak Bozkurt, Melih Akcalar, Seray Balci, Sinan Arat, Anil Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase |
title | Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase |
title_full | Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase |
title_fullStr | Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase |
title_full_unstemmed | Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase |
title_short | Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase |
title_sort | carotid artery-cavernous segment injury during an endoscopic endonasal surgery: a case report and literature review of the overlooked option for surgical trapping in the hyperacute phase |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670996/ https://www.ncbi.nlm.nih.gov/pubmed/34917447 http://dx.doi.org/10.1055/s-0041-1740511 |
work_keys_str_mv | AT kahilogullarigokmen carotidarterycavernoussegmentinjuryduringanendoscopicendonasalsurgeryacasereportandliteraturereviewoftheoverlookedoptionforsurgicaltrappinginthehyperacutephase AT bahadırburak carotidarterycavernoussegmentinjuryduringanendoscopicendonasalsurgeryacasereportandliteraturereviewoftheoverlookedoptionforsurgicaltrappinginthehyperacutephase AT bozkurtmelih carotidarterycavernoussegmentinjuryduringanendoscopicendonasalsurgeryacasereportandliteraturereviewoftheoverlookedoptionforsurgicaltrappinginthehyperacutephase AT akcalarseray carotidarterycavernoussegmentinjuryduringanendoscopicendonasalsurgeryacasereportandliteraturereviewoftheoverlookedoptionforsurgicaltrappinginthehyperacutephase AT balcisinan carotidarterycavernoussegmentinjuryduringanendoscopicendonasalsurgeryacasereportandliteraturereviewoftheoverlookedoptionforsurgicaltrappinginthehyperacutephase AT aratanil carotidarterycavernoussegmentinjuryduringanendoscopicendonasalsurgeryacasereportandliteraturereviewoftheoverlookedoptionforsurgicaltrappinginthehyperacutephase |