Endovascular Bailout: Life-saving Covered Stent in a Case of Intraoperative Vertebral Artery Injury

Iatrogenic vertebral artery pseudoaneurysm is rare, yet a critical condition that must be identified and treated promptly. A vertebral artery pseudoaneurysm may cause complications like thromboembolism and even arterial rupture, leading to posterior circulation stroke. We present a case of a 72-year-old male patient with a right vertebral artery pseudoaneurysm following surgery for cervical myelopathy. A pseudoaneurysm in the V2 segment of the right vertebral artery was confirmed by diagnostic angiogram. The patient was transferred to the catheterization laboratory immediately, and the decision to proceed with an endovascular approach using a covered stent to preserve the right vertebral artery was made. The patient did not develop any postsurgical complications and has now fully recovered. This case highlights that emergency endovascular intervention using a covered stent can be a promising therapeutic option in cases of pseudoaneurysms following open surgery.