Treatment of Iatrogenic Internal Carotid Artery Laceration and Carotid Cavernous Fistula with

Summary: The risk of fatal injury of the internal carotid artery (ICA) and surrounding anatomy during transsphe-noidal surgery for pituitary adenoma is the most severe potential complication associated with this particular ap-proach. We present a case in which iatrogenic injury to a patient’s ICA and resultant carotid cavernous fistula and massive hemorrhage was successfully managed with the emergency placement of an endovascular stent-graft. Both findings in the relevant literature and practical consider-ations concerning both stent-grafts and other more com-monly used options for the treatment of iatrogenic ICA injury are discussed. Although experience and thorough knowledge of the relevant anatomy can prevent many potential complications associated with transsphenoidal sur