| Abstract: | This case illustrates successful treatment of alarge postoperative intrasellar pseudoaneurysm with apolytetrafluoroethylene (PTFE)-covered stent. The advantages andpotential disadvantages of this novel method of treatment arediscussed. A previously healthy 59-year-old man underwenttranssphenoidal operative treatment for hypophyseal macroadenoma,complicated by bleeding. On the 17th postoperative day thepatient had profuse arterial bleeding from his nose requiring posteriortamponade. Subsequent angiography of the left internal carotid artery(ICA) revealed a large pseudoaneurysm located intrasellarly, with theorifice in the anteromedial wall in the ophthalmic segment of the ICA.Surgical treatment of the pseudoaneurysm was considered very risky. A12-mm PTFE-covered stent (JoMed, Ulestraten, Netherlands), manuallycompressed on a PTCA-balloon (Maxxum 4.5/13 mm, Boston Scientific,Ireland) was endovascularly delivered covering the orifice of thepseudoaneurysm. Control angiography immediately after the interventionand one year later revealed no flow into the pseudoaneurysm and the ICAwas fully patent. In conclusion, deployment of a PTFE-covered stentproved to be feasible and successful in the treatment of an intrasellariatrogenic ICA pseudoaneurysm. Adequate anticoagulative treatment afterthe procedure is essential to prevent thrombotic complications. |
