Please use this identifier to cite or link to this item:
|Scopus||Web of Science®||Altmetric|
Full metadata record
|dc.identifier.citation||Neurosurgery, 2013; 73(SUPPL. 2):261-269||en|
|dc.description.abstract||BACKGROUND: Injury to the internal carotid artery (ICA) during endoscopic endonasal skull base surgery is a feared complication that is not well studied or reported. OBJECTIVE: To evaluate the incidence, to identify potential risk factors, and to present management strategies and outcomes of ICA injury during endonasal skull base surgery at our institution. METHODS: We performed a retrospective review of all endoscopic endonasal operations performed at our institution between 1998 and 2011 to examine potential factors predisposing to ICA injury. We also documented the perioperative management and outcomes after injury. RESULTS: There were 7 ICA injuries encountered in 2015 endonasal skull base surgeries, giving an incidence of 0.3%. Most injuries (5 of 7) involved the left ICA, and the most common diagnosis was chondroid neoplasm (chordoma, chondrosarcoma; 3 of 7 [2% of 142 cases]). Two injuries occurred during 660 pituitary adenoma resections (0.3%). The paraclival ICA segment was the most commonly injured site (5 of 7), and transclival and transpterygoid approaches had a higher incidence of injury, although neither factor reached statistical significance. Four of 7 injured ICAs were sacrificed either intraoperatively or postoperatively. No patient suffered a stroke or neurological deficit. There were no intraoperative mortalities; 1 patient died postoperatively of cardiac ischemia. One of the 3 preserved ICAs developed a pseudoaneurysm over a mean follow-up period of 5 months that was treated endovascularly. CONCLUSION: ICA injury during endonasal skull base surgery is an infrequent and manageable complication. Preservation of the vessel remains difficult. Chondroid tumors represent a higher risk and should be resected by surgical teams with significant experience.||en|
|dc.description.statementofresponsibility||Paul A. Gardner, Matthew J. Tormenti, Harshita Pant, Juan C. Fernandez-Miranda, Carl H. Snyderman, Michael B. Horowitz||en|
|dc.publisher||Lippincott Williams & Wilkins||en|
|dc.rights||Copyright © by the Congress of Neurological Surgeons||en|
|dc.subject||Complications; Endoscopic skull base surgery; Internal carotid artery; Vascular injury||en|
|dc.title||Carotid artery injury during endoscopic endonasal skull base surgery: incidence and outcomes||en|
|Appears in Collections:||Medicine publications|
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.