Transarterial embolization in the management of life-threatening hemorrhage after maxillofacial trauma: a case report and review of literature

• Published in: The American journal of emergency medicine Vol. 26; no. 4; pp. 516.e3 - 516.e5
• Main Authors: Liu, Wei-Hsiu, MD, Chen, Yuan-Hao, MD, Hsieh, Cheng-Ta, MD, Lin, En-Yuan, MD, Chung, Tzu-Tsao, MD, Ju, Da-Tong, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2008; Elsevier Limited
• Subjects: Adult; Blood pressure; Carotid arteries; Carotid Artery Injuries - diagnostic imaging; Carotid Artery Injuries - etiology; Carotid Artery Injuries - therapy; Catheters; Cerebral Angiography; Embolization; Embolization, Therapeutic; Emergency; Emergency medical care; Epistaxis; Hemorrhage; Hemorrhage - etiology; Hemorrhage - therapy; Hospitals; Humans; Injuries; Male; Maxillofacial Injuries - complications; Medical imaging; Necrosis; Neurological disorders; Patients; Surgeons; Traffic accidents & safety; Trauma; Veins & arteries
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2007.07.036

Abstract There are many reasons for hypotension in trauma patients. Life-threatening hemorrhage associated with maxillofacial trauma is considered rare. Here, we present a 25-year-old patient with maxillofacial trauma complicated by life-threatening hemorrhage after a traffic accident. At the emergency department, massive epistaxis was noted. Nasal packing and blood transfusion were performed, but vital signs of the patient were still unstable. Cerebral angiography revealed contrast extravasation from the left superficial temporal and internal maxillary arteries of the left external carotid artery. After transarterial embolization was performed, the hemorrhage immediately stopped. When common treatment such as nasal packing, correction of coagulopathy, reduction of fractures, and arterial ligation fails to control the hemorrhage, transarterial embolization can offer a safe alterative to surgical exploration.