Iatrogenic pseudoaneurysm: a rare complication of sinonasal surgery

Abstract

Objective We report 2 patients with iatrogenic pseudoaneurysms, which developed following sinus surgery. Method Case reports and a review of literature of the management of iatrogenic pseudoaneurysm. Results For one patient who presented with massive epistaxis, the only lifesaving option available was to perform an urgent angiogram followed by selective embolization of the feeding vessel. In the second patient who presented with persistent nasal obstruction and discharge and no epistaxis, a traumatic aneurysm of the internal carotid artery was demonstrated on magnetic resonance imaging scan that was later confirmed by angiography; he, however, declined further treatment. Conclusion Iatrogenic pseudoaneurysms that develop following a vascular injury, though rare, can cause life-threatening epistaxis or a thromboembolism. In this report, we describe 2 different manifestations of iatrogenic vascular malformations following sinus surgery. The role of angiography and subsequent endovascular therapy in the management of these lesions is emphasized.