Use of Foley catheter in control of internal carotid hemorrhage during endoscopic endonasal surgery

Alicandri‐Ciufelli, Matteo; Maccarrone, Francesco; Botti, Cecilia; Pavesi, Giacomo; Presutti, Livio

doi:10.3897/folmed.63.e56461

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…In several cases, initial packing was successful with Merocel, oxycellulose, or Gelfoam [ 1 ]. Successful balloon packing of the ICA lesion has also been reported [ 1 , 26 ]. In addition, bipolar coagulation was used successfully to manage bleeding from smaller ICA perforations [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Internal Carotid Injury during Skull Base Surgery—Case Report and a Review of the Literature

et al. 2022

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Iatrogenic injury of the internal carotid artery (ICA) is a rare, and probably underreported, complication of transnasal endoscopic skull base surgery. Although treatment algorithms have been suggested, there is no definite consensus or guideline for the management of this severe complication. We describe a case of ICA injury that occurred during a transsphenoidal biopsy of a tumor in the cavernous sinus and we present a treatment algorithm for managing this complication. We reviewed the articles published from 1998 to 2021, reporting on major vascular injury during transnasal endoscopic skull base surgery and endonasal endoscopic surgery, and we compare the methods and results of ICA injury management reported in the literature with the presented case. The most promising treatment for ICA injury might be packing with a muscle graft initially, then performing an endovascular intervention.

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Section: Discussionmentioning

confidence: 99%

Internal Carotid Injury during Skull Base Surgery—Case Report and a Review of the Literature

et al. 2022

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“…Minor bleeding episodes can be addressed using bipolar coagulation for hemostasis, 1 breaks with high bleeding flow can be packed and locally pressed to stop bleeding. For instance, multiple Foley urologic catheters are packed for hemostasis, 10 hemostasis using crushed muscle packing, 11 cottonoid and hemostatic materials are packed to stop bleeding 2 . For the purpose of reducing bleeding and maintaining blood pressure, in addition to blood transfusions, anesthesiologists can also employ adenosine to induce transient hypotension, which is highly advantageous for minimizing bleeding and is both secure and efficient 8,12 .…”

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confidence: 99%

Report on Pseudoaneurysm Caused by Injury of Internal Carotid Artery During Endoscopic Pituitary Surgery and Rebleeding After Treatment With Willis Covered Stent

Xiao,

Chen,

et al. 2024

Journal of Craniofacial Surgery

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Objective: Report on a case of pseudoaneurysm which was caused by injury of the internal carotid artery (ICA) during endoscopic endonasal surgery (EES), which was followed by rebleeding after treatment with a Willis covered stent. Methods: A woman, aged 68, underwent EES for the treatment of a pituitary adenoma. During the surgery, the right ICA was injured, and successfully hemostasis by packed with cottonoid and gelatin sponge. Besides, cerebral angiography was performed in the interventional operating room for the purpose of discovering the formation of a pseudoaneurysm in the cavernous sinus segment of ICA, which was treated with a covered stent. After successfully placing the covered stent, the patient was promptly transferred to the general operating room for the removal of the cottonoid and to address the bleeding once again. The authors employ crushed muscles and cottonoid to locally compress and stop bleeding. Owing to concerns about the risk of rebleeding in the patient, after stent implantation, the patient did not utilize antiplatelet drugs. After the surgery, the patient developed occlusion of the right ICA and massive cerebral infarction in the right hemisphere. Dehydration, anti-infection, rehabilitation, hyperbaric oxygen, as well as related treatments, were given. The cottonoid was removed in EES 2 months postsurgery, and no instances of bleeding were observed. Six months after surgery, the patient had clear consciousness and hemiplegia in the left limb, with a Glasgow Outcome Scale score of 4. Results: The ICA was injured during EES, which resulted in the formation of a pseudoaneurysm, the Willis stent was adopted for treatment, and there was a risk of rebleeding after the nasal packing (cottonoid, crushed muscles) was removed immediately. Conclusions: The ICA was injured during EES after bleeding was controlled by packing with cottonoid, crushed muscles, etc, subsequently, the patient was given intravascular treatment, it is advised to make thorough preparations and, after a suitable period, remove nasal packing in the hybrid operating room to address unexpected situations and unforeseen circumstances.

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Use of Foley catheter in control of internal carotid hemorrhage during endoscopic endonasal surgery

Cited by 2 publications

References 5 publications

Internal Carotid Injury during Skull Base Surgery—Case Report and a Review of the Literature

Internal Carotid Injury during Skull Base Surgery—Case Report and a Review of the Literature

Report on Pseudoaneurysm Caused by Injury of Internal Carotid Artery During Endoscopic Pituitary Surgery and Rebleeding After Treatment With Willis Covered Stent

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