Internal carotid artery injury during endoscopic transsphenoidal pituitary surgery: risk factors, management

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2023-12-04 DOI:10.1016/j.neuchi.2023.101515

Xin Ma , Yu Zhang , Zhi-Jun Yang , Bo Wang , Xin-Chao Wang , Chao Zhang , Pi-Nan Liu , Zhi-Yong Bi

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引用次数: 0

Abstract

Background

Transsphenoidal surgeons should try to avoid internal carotid artery (ICA) injury but also be prepared to manage it. We analyzed our experience with ICA injury during endoscopic transsphenoidal pituitary surgery and present associated risk factors and a management protocol.

Methods

We retrospectively reviewed and analyzed the medical records of 1596 patients who underwent endoscopic transsphenoidal surgery for pituitary tumor resection in our institution from January 2009 to October 2022.

Results

Six patients experienced an ICA injury. All received timely and effective hemostasis with immediate direct tamponade followed by endovascular treatment. No serious postoperative complications occurred.

Conclusions

We proposed a treatment plan for ICA injuries encountered during endoscopic transsphenoidal surgery and described our hemostasis process, methods of endovascular treatment, and means of postoperative follow-up in detail.

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经蝶窦垂体内窥镜手术中颈动脉损伤:危险因素及处理

背景:经蝶窦外科医生应尽量避免颈内动脉(ICA)损伤，但也要准备好处理它。我们分析了内镜下经蝶窦垂体手术中ICA损伤的经验，并提出了相关的危险因素和处理方案。方法回顾性分析我院2009年1月至2022年10月1596例经蝶窦内镜下垂体瘤切除术患者的病历。结果6例患者发生ICA损伤。所有患者均及时有效止血，立即直接填塞，然后进行血管内治疗。术后未发生严重并发症。结论我们提出了内镜下经蝶窦手术中ICA损伤的治疗方案，并详细描述了我们的止血过程、血管内治疗方法和术后随访方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.