Treatment of iatrogenic V2 segment vertebral artery pseudoaneurysm using Pipeline flow-diverting stent

Hakeem J Shakir; Patrick J Rooney; Leonardo Rangel-Castilla; Parham Yashar; Elad I Levy

doi:10.4103/2152-7806.196235

Treatment of iatrogenic V2 segment vertebral artery pseudoaneurysm using Pipeline flow-diverting stent

Surg Neurol Int. 2016 Dec 20:7:104. doi: 10.4103/2152-7806.196235. eCollection 2016.

Authors

Hakeem J Shakir¹, Patrick J Rooney¹, Leonardo Rangel-Castilla¹, Parham Yashar², Elad I Levy³

Affiliations

¹ Department of Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
² California Neurosurgical Institute, Valencia, California, USA.
³ Department of Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York, USA.

Abstract

Background: Iatrogenic injury to the vertebral artery is a rare but potential complication of cervical spine surgery. Previous authors have commented on the use of flow-diverting stents for treatment of aneurysms of the V3 segment of the vertebral artery.

Case description: Here, we report a case in which injury occurred at the V2 segment of the vertebral artery with the development of a pseudoaneurysm, which was found on angiography. After decompressing the spinal cord from an epidural hematoma, the pseudoaneurysm was treated by deploying two Pipeline flow-diverting stents (Medtronic, Minneapolis, MN). Obliteration of the pseudoaneurysm was noted on follow-up angiography 4 days after the treatment.

Conclusion: This case highlights a unique treatment at a region which, to our knowledge, has not been mentioned in the literature.

Keywords: Iatrogenic complication; Pipeline embolization device; V2 segment; pseudoaneurysm; vertebral artery.

Publication types

Case Reports