Internal carotid artery (ICA) injury is a rare but potentially life-threatening complication of skull base and neck surgery. Although usually manifested by massive intraoperative haemorrhage, impairment of the ICA might go unnoticed and result in formation of a pseudoaneurysm, causing delayed bleeding. Often additional complications are observed such as thrombosis, spasm, embolism or carotico-cavernous fistula formation. The risk of carotid artery injury in aggressive endonasal skull base surgical interventions ranges from 1% to 9%. Digital subtracted angiography remains the gold standard for evaluation of patients with iatrogenic carotid artery injury as it allows for endovascular treatment at the time of the procedure. Endovascular embolization is currently the preferred method for treating ICA pseudoaneurysms and a successful alternative to the surgical approach. Even though endovascular approaches are considered the safer option, delayed complications have been registered, such as endovascular coil extrusion and migration, which increases the risk of further episodes of bleeding. We present our experience with late coil extrusion in a patient who was previously treated with flow diverter stent and coiling for iatrogenic ICA pseudoaneurysm.

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The Comaneci device offers a new promising and reliable technique that can safely support aneurysm coiling occlusion even in a rupture environment. However, long term monitoring of patients treated by this device is mandatory.

Summary The Eurasian Griffon Vulture Gyps fulvus is a large Palearctic, Indohimalayan and Afrotropical Old-World vulture. The species’ range is vast, encompassing territories from the Pyrenees to the Himalayas. We reviewed and analysed a long-term data set for Griffon Vulture in the Balkans to estimate the change in its population size and range between 1980 and 2019. After a large historical decline, the Griffon Vulture population slightly increased in the last 39 years (λ = 1.02) and reached 445–565 pairs in 2019. We recorded a gradual increase of Griffon Vulture subpopulations in Serbia (λ = 1.08 ± 0.003), Bulgaria (λ = 1.08 ± 0.003) and Croatia (λ = 1.05 ± 0.005) and steep to a moderate decline of the species subpopulations in Greece (λ = 0.88 ± 0.005) and North Macedonia (λ = 0.94 ± 0.01). However, species range contracted to half of its former range in the same period. It occurred in 42 UTM squares in the 1980–1990 period and only 20 UTM squares between 2011 and 2019 and concentrated into three source subpopulations in Bulgaria, Serbia, and Croatia. Following reintroductions of the Griffon Vulture in Bulgaria, new colonies were formed at three novel localities after 2010. Regular movements of individuals between the different subpopulations exist nowadays. Therefore, preservation of both current and former core areas used for breeding and roosting is essential for species conservation in the region. However, the Griffon Vulture still faces severe threats and risk of local extinction. Various hazards such as poisoning, collision with energy infrastructure, disturbance and habitat alteration are depleting the status of the Balkan population and its full recovery. Further studies should analyse age-specific survival and mortality, recruitment, genetic relatedness, spatial use to inform the viability of this population in the future.

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