Mary In-Ping Huang Cobb1, Shahid Nimjee, L Fernando Gonzalez, David Woojin Jang, Ali Zomorodi. 1. *Duke University Hospitals, Department of Neurosurgery, Durham, North Carolina; ‡The Ohio State University Hospitals, Department of Neurosurgery, Columbus, Ohio; §Duke University Hospitals, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Durham, North Carolina.
Abstract
BACKGROUND AND IMPORTANCE: Iatrogenic internal carotid artery (ICA) injuries during endoscopic endonasal approach (EEA) surgeries are associated with a high morbidity and mortality, with few acceptable methods described for repair. CLINICAL PRESENTATION: A 13-year-old girl with a large anterior and central skull base osteoblastoma incurred an iatrogenic cavernous ICA injury during a staged EEA approach. Intraoperative angiogram was performed with balloon-assisted EEA primary microsurgical repair of the lacerated ICA. CONCLUSION: By integrating current techniques commonly used in open aneurysm surgeries and in endovascular procedures, we developed a rapid, safe technique to repair an EEA-associated iatrogenic ICA injury.
BACKGROUND AND IMPORTANCE: Iatrogenic internal carotid artery (ICA) injuries during endoscopic endonasal approach (EEA) surgeries are associated with a high morbidity and mortality, with few acceptable methods described for repair. CLINICAL PRESENTATION: A 13-year-old girl with a large anterior and central skull base osteoblastoma incurred an iatrogenic cavernous ICA injury during a staged EEA approach. Intraoperative angiogram was performed with balloon-assisted EEA primary microsurgical repair of the lacerated ICA. CONCLUSION: By integrating current techniques commonly used in open aneurysm surgeries and in endovascular procedures, we developed a rapid, safe technique to repair an EEA-associated iatrogenic ICA injury.
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