Treatment of Post Traumatic Internal Carotid Artery Pseudo Aneurysm with Intravascular Coil Embolization

Introduction: Vascular complications such as bleeding and pseudoaneurysm following an endoscopic trans-sphenoidal approach for the basal skull pathology are rare but when it occurs it brings a significant risk of morbidity and mortality along with it. Intraoperative bleeding can be managed with manual packing and in case of pseudoaneurysm formation, it can be successfully managed with endovascular coiling.Case presentation: One month after an endoscopic sphenoidal resection of mucocele. A 49-year-old female presented with massive left sided epistaxis due to formation and rupture of pseudoaneurysm at left cavernous segment of internal carotid artery. She was managed with multiple coil embolization of pseudoaneurysm.Conclusion: A patient with pseudoaneurysm formation following an endoscopic trans-sphenoidal approach for a mucocele resection was successfully managed by the emergency endovascular coiling, with complete obliteration of the aneurysm and bleeding while maintaining the vessel patency. This approach is less invasive, quick as well as safe and do not require long term anticoagulation. However, long term follow and larger sample are required to evaluate its efficacy