Repair of carotid artery perforations during transsphenoidal surgery.

Background: Hemorrhage from carotid artery injury during transsphenoidal surgery is an unusual, but potentially fatal complication.

Methods: Among six patients experiencing laceration or perforation of the carotid artery, we treated four with a new technique using Teflon mesh and methyl methacrylate to form an external, artificial wall over the laceration and the carotid artery.

Results: In all four cases, hemorrhage was successfully controlled without neurologic deficit to the patient or complications frequently associated with the standard technique of nasal and sphenoid sinus packing removal.

Conclusions: Our new technique may be superior to packing alone, as well as potentially life-saving to the patient.