RT Journal Article
SR Electronic
T1 Iatrogenic Middle Cerebral Artery Ruptured Pseudoaneurysm Successfully Treated With a Pipeline Embolization Device
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 190
OP 193
DO 10.31486/toj.19.0122
VO 21
IS 2
A1 Tyler Scullen
A1 Mansour Mathkour
A1 Jessica R. Carr
A1 Aaron S. Dumont
A1 Peter S. Amenta
YR 2021
UL http://www.ochsnerjournal.org/content/21/2/190.abstract
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.