The objective of this study is to provide an update on endovascular treatments for iatrogenic internal carotid artery (ICA) injuries following endonasal surgery. A systematic review of the literature was performed by using Medline, Cochrane library, and Scopus from 1999 to 2019. We used a combination of the MeSH terms “internal carotid artery,” “iatrogenic disease,” and “endovascular procedure.” Twenty-six articles including 46 patients were identified for in this systematic review. The mean age of the patients was 49 years (CI: ± 4.2). The most common site of ICA injury was in cavernous segment (18 patients; 39%). The most common type of iatrogenic ICA injury was a traumatic pseudoaneurysm documented in 28 patients (60%). Endoluminal reconstruction was performed using covered stents in 28 patients, the Pipeline embolization device (PED) in 13 patients, the Surpass flow diverter device in three, the SILK flow diverter in one, and one case was treated using a combined approach of a covered stent and a PED. Flow diversion and covered stents resulted in a good clinical outcome in 94% and 89% of patients, respectively. This difference did not reach statistical significance (p = 1.0). Even though this systematic review was limited due to articles of small sample sizes and considerable heterogeneity, the results indicate that flow diverting devices and covered stents are good therapeutic options for endoluminal reconstruction of iatrogenic ICA injuries following endonasal surgery.

本研究的目的是提供鼻内手术后医源性颈内动脉 (ICA) 损伤的血管内治疗的最新进展。使用 Medline、Cochrane 库和 Scopus 对 1999 年至 2019 年的文献进行了系统回顾。我们使用了 MeSH 术语“颈内动脉”、“医源性疾病”和“血管内手术”的组合。在本系统评价中确定了 26 篇文章，包括 46 名患者。患者的平均年龄为 49 岁（CI：± 4.2）。ICA 损伤最常见的部位是海绵体段（18 名患者；39%）。最常见的医源性 ICA 损伤类型是 28 名患者 (60%) 记录的外伤性假性动脉瘤。28 名患者使用覆膜支架进行腔内重建，管道栓塞装置（PED）13例，Surpass分流器3例，SILK分流器1例，1例采用覆膜支架和PED联合治疗。分流术和覆膜支架分别为 94% 和 89% 的患者带来了良好的临床结果。这种差异没有达到统计学显着性（p  = 1.0）。尽管由于样本量小且具有相当大的异质性，该系统评价受到限制，但结果表明，分流装置和覆膜支架是鼻内手术后医源性 ICA 损伤的腔内重建的良好治疗选择。