Usachev D Yu, Lukshin V A, Yakovlev S B, Kalinin P L, Sharipov O I, Kutin M A, Akhmedov A D, Bocharov A V, Aref'ev A M
Burdenko Neurosurgical Institute.
Zh Vopr Neirokhir Im N N Burdenko. 2016;80(5):116-123. doi: 10.17116/neiro2016805116-122.
We describe a clinical case of surgical treatment of a cavernous internal carotid artery (ICA) pseudoaneurysm that developed due to damage to the artery during transsphenoidal resection of pituitary adenoma. Clinically, the aneurysm presented with episodes of profuse epistaxis that required tight nasal packing. Given the presence of an open circle of Willis, the patient underwent staged surgery that included the creation of a high-flow extra-intracranial anastomosis, subsequent endovascular ICA occlusion at the pseudoaneurysm level using balloon-assisted coiling, and endoscopic debridement of the nasal cavity. The combined surgical treatment of this rare complication successfully excluded the pseudoaneurysm from the bloodstream, which led to complete regression of nasal bleeding.
我们描述了一例海绵窦段颈内动脉（ICA）假性动脉瘤的外科治疗临床病例，该假性动脉瘤是在垂体腺瘤经蝶窦切除术中因动脉损伤而形成的。临床上，该动脉瘤表现为反复大量鼻出血，需要进行鼻腔紧密填塞。鉴于存在Willis环开放，患者接受了分期手术，包括建立高流量颅外-颅内吻合术、随后在假性动脉瘤水平使用球囊辅助弹簧圈栓塞进行颈内动脉血管内闭塞，以及鼻腔内镜清创术。这种罕见并发症的联合外科治疗成功地将假性动脉瘤排除在血流之外，从而使鼻出血完全消退。
