Erschienen in:
01.06.2003 | Case Report
Intrasellar Iatrogenic Carotid Pseudoaneurysm: Endovascular
Treatment with a Polytetrafluoroethylene-Covered Stent
verfasst von:
R. L. Vanninen, H. I. Manninen, J. Rinne
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 3/2003
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Abstract
This case illustrates successful treatment of a
large postoperative intrasellar pseudoaneurysm with a
polytetrafluoroethylene (PTFE)-covered stent. The advantages and
potential disadvantages of this novel method of treatment are
discussed. A previously healthy 59-year-old man underwent
transsphenoidal operative treatment for hypophyseal macroadenoma,
complicated by bleeding. On the 17th postoperative day the
patient had profuse arterial bleeding from his nose requiring posterior
tamponade. Subsequent angiography of the left internal carotid artery
(ICA) revealed a large pseudoaneurysm located intrasellarly, with the
orifice in the anteromedial wall in the ophthalmic segment of the ICA.
Surgical treatment of the pseudoaneurysm was considered very risky. A
12-mm PTFE-covered stent (JoMed, Ulestraten, Netherlands), manually
compressed on a PTCA-balloon (Maxxum 4.5/13 mm, Boston Scientific,
Ireland) was endovascularly delivered covering the orifice of the
pseudoaneurysm. Control angiography immediately after the intervention
and one year later revealed no flow into the pseudoaneurysm and the ICA
was fully patent. In conclusion, deployment of a PTFE-covered stent
proved to be feasible and successful in the treatment of an intrasellar
iatrogenic ICA pseudoaneurysm. Adequate anticoagulative treatment after
the procedure is essential to prevent thrombotic complications.