CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2017 April;1(1):18-22

DOI: 10.23736/S2532-3466.17.00101-1

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Control of severe hemorrhage by transarterial embolization through interventional radiology and review of embolic materials

Pooja GANGWANI, Ryan RICHARDS, Michael ERLICHMAN, Hillel EPHROS ✉

St. Joseph Regional Medical Center, Paterson, NJ, USA

The aim of this study was to present an evidence-based approach to the control and management of intractable hemorrhage in complex maxillofacial trauma patients, to review pertinent vascular anatomy and to describe various materials used for transarterial embolization (TAE). Here we discuss a 39-year-old male who sustained a life threatening hemorrhage of bilateral internal maxillary artery with multiple facial fractures. Local measures including oronasal packing, placement of Foley catheters, and temporary reduction of facial fractures were unsuccessful. External carotid artery ligation was considered, however embolization of bilateral internal maxillary arteries was performed through interventional radiology. Massive oronasal bleeding was successfully controlled by transarterial embolization of bilateral internal maxillary artery. Patient was hemodynamically stable at the end of the procedure. Severe hemorrhage associated with mid facial trauma can result in airway compromise and hypovolemic shock. Control of life threatening hemorrhage reduces morbidity and mortality associated with severe exsanguination.

KEY WORDS: Hemorrhage - Embolization, therapeutic - Radiology, interventional