Management of patients with iatrogenic pseudoaneurysm of carotid and vertebral artery

Abstract

To evaluate the formation mechanism and management of iatrogenic pseudoaneurysms of carotid and vertebral artery. Four patients with iatrogenic pseudoaneurysms were identified at our department from April 2004 to February 2009. One was caused by radiotherapy and the others due to surgical trauma. Two parents were treated with balloon occlusion of parent artery. Stent grafts were deployed in the other two patients to ensure the patency of parent arteries and occlusion of pseudoaneurysm. One patient with pseudoaneurysm of internal carotid artery developed decompensation after balloon occlusion. Unfortunately, long-term paralysis occurred after decompressive craniectomy. The other patients with vertebral artery pseudoaneurysm achieved an excellent outcome after balloon occlusion. The therapeutic effect of stent grafts in two internal carotid artery pseudoaneurysms was achieved. No recurrence was found during a post-operative follow-up of 15 months to 6 years. Iatrogenic pseudoaneurysms of carotid and vertebral artery deserve a priority attention. Cerebrovascular angiography should be performed if needed. The neurosurgical intervention for iatrogenic pseudoaneurysms may yield an excellent outcome.