PT - JOURNAL ARTICLE AU - Tyler Scullen AU - Mansour Mathkour AU - Jessica R. Carr AU - Aaron S. Dumont AU - Peter S. Amenta TI - Iatrogenic Middle Cerebral Artery Ruptured Pseudoaneurysm Successfully Treated With a Pipeline Embolization Device AID - 10.31486/toj.19.0122 DP - 2021 Jun 20 TA - Ochsner Journal PG - 190--193 VI - 21 IP - 2 4099 - http://www.ochsnerjournal.org/content/21/2/190.short 4100 - http://www.ochsnerjournal.org/content/21/2/190.full SO - Ochsner J2021 Jun 20; 21 AB - Background: Endovascular advances have shifted the treatment algorithms for traumatic intracranial pseudoaneurysms (IPs) from vessel sacrifice to reconstruction. The Pipeline embolization device (PED) is a flow-diverting stent that promotes endothelialization across the lesion and reconstitutes the parent vessel lumen.Case Report: A 66-year-old male with a history of a right orbital apex lesion presented for biopsy with ophthalmology. Ophthalmology performed a right lateral orbitotomy complicated by brisk arterial bleeding from a proximal right middle cerebral artery (MCA) pseudoaneurysm. The MCA pseudoaneurysm was treated endovascularly with a PED, resulting in immediate stasis of contrast within the lesion without compilation. Interval follow-up angiograms 6 weeks and 6 months after the procedure showed no evidence of recurrence and a widely patent stent.Conclusion: The PED provided a rapid, minimally invasive, and durable treatment option for an acutely ruptured IP. We illustrate that endovascular management with flow diversion can be effectively used in select cases and provides a way to reconstruct the damaged vessel lumen and obliterate the aneurysm.