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Successful Treatment of Iatrogenic Vertebral Artery Pseudoaneurysm with Coil Embolization: Case Report

Chang Wei Zhang, Seidu A Richard, Chong Wu, Ting Wang, Lun Xing Lui and Xiao Dong Xie

Introduction: Iatrogenic vertebral artery injury (IVAI) is a rare intricacy during cervical spine screw fixation or removal surgery. The overall incidence of vertebral artery (VA) injury related to craniocervical surgery is about 0.2% in literature.
Case presentation: We report a case of 52-year-old male who suffered iatrogenic vertebral artery injury (VAI) as a result of surgical removal of C1-2 screw that was successfully fixed at posterior cervical spine on account of traumatic atlantoaxial dislocation four (4) years ago. The surgical removal was on going at a periphery hospital when the patient suffered this intricacy with massive bleeding. He was immediately transferred to our facility. CT angiography done at our facility revealed a pseudoaneurysm measuring about 5.5 cm in diameter at the cervical region.
Conclusions: We successfully treated this pseudoaneurysm with coil embolization without any further neurological deficits. Although the occurrence of iatrogenic VAI pseudoaneurysm as a result of the removal of C1-2 screw is extremely rare, it occurrence can be very fetal with very serious neurological deficits or death.