Ludwig D Orozco1, Razvan F Buciuc, Andrew D Parent. 1. Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA. lorozco-castillo@umc.edu
Abstract
BACKGROUND AND IMPORTANCE: Prominent intercavernous sinuses may result in vigorous bleeding during transsphenoidal resection of pituitary microadenomas and lead to incomplete or aborted tumor resection. We report the use of coil embolization of the intercavernous sinuses to prevent uncontrollable bleeding before transsphenoidal surgery is reattempted. CLINICAL PRESENTATION: A 40-year-old man with Cushing disease underwent an attempt for transsphenoidal resection of an adrenocorticotrophic hormone--producing pituitary microadenoma. This approach was aborted secondary to profuse intercavernous sinus bleeding. The patient underwent endovascular coil embolization of the anterior intercavernous sinuses with complete obliteration. Six weeks later, he underwent successful transsphenoidal resection of the microadenoma. CONCLUSION: To the best of our knowledge, this is the first report of successful coil embolization of the intercavernous sinuses to prevent uncontrolled bleeding before transsphenoidal resection of pituitary microadenomas.
BACKGROUND AND IMPORTANCE: Prominent intercavernous sinuses may result in vigorous bleeding during transsphenoidal resection of pituitary microadenomas and lead to incomplete or aborted tumor resection. We report the use of coil embolization of the intercavernous sinuses to prevent uncontrollable bleeding before transsphenoidal surgery is reattempted. CLINICAL PRESENTATION: A 40-year-old man with Cushing disease underwent an attempt for transsphenoidal resection of an adrenocorticotrophic hormone--producing pituitary microadenoma. This approach was aborted secondary to profuse intercavernous sinus bleeding. The patient underwent endovascular coil embolization of the anterior intercavernous sinuses with complete obliteration. Six weeks later, he underwent successful transsphenoidal resection of the microadenoma. CONCLUSION: To the best of our knowledge, this is the first report of successful coil embolization of the intercavernous sinuses to prevent uncontrolled bleeding before transsphenoidal resection of pituitary microadenomas.