Rupture from cavernous internal carotid artery pseudoaneurysm 11 years after transsphenoidal surgery
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Abstract
Carotid artery pseudoaneurysm is a rare complication
of transsphenoidal surgery, usually diagnosed within
90 days post procedure. Pseudoaneurysm rupture may
present with severe epistaxis or carotid cavernous fistula
(CCF) with significant morbidity and mortality. We present
a case of epistaxis from pseudoaneurysm rupture over
a decade after transsphenoidal surgery. The pseudoaneurysm
was treated with staged balloon-assisted coiling,
endonasal mucosal flap repair and interval flow-diverting
stent insertion. This case illustrates that pseudoaneurysms
develop and rupture regardless of postoperative
time course after transsphenoidal surgery, and the treatment
complexities involving combined endovascular and
endonasal techniques.
