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Massive hemorrhage from internal carotid artery pseudoaneurysm successfully treated by transcatheter arterial embolization with assessment of regional cerebral oxygenation.

Abstract：

:A 54-year-old male presented with intermittent massive hemorrhage from recurrent oropharyngeal cancer. The angiogram showed the encasements at the main trunk of the left internal carotid artery (ICA) and external carotid artery (ECA). Transcatheter arterial embolization (TAE) of the ECA with gelatin sponge particles and microcoils was performed. However, hemorrhage recurred several hours after the initial TAE. The second angiogram showed a large pseudoaneurysm of the ICA developing at the encasement on the initial angiogram. As a simple neurologic test, regional cerebral oxygenation (rSO2) was assessed with and without manual compression of the common carotid artery (CCA). With compression of the left CCA, the rSO2 did not change. We therefore performed isolation of the pseudoaneurysm. We embolized proximally and distally to the ICA pseudoaneurysm with microcoils and the pseudoaneurysm disappeared. No major complications occurred and no massive hemorrhage recurred until death from the cancer. TAE was an effective treatment for massive hemorrhage caused by tumor invasion to ICA. Assessment of rSO2 was a simple and useful neurologic test predicting the cerebral blood flow to prevent complications of TAE.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

Kakizawa H,Toyota N,Hieda M,Hirai N,Tachikake T,Horiguchi J,Ito K

doi

10.1007/s00270-004-0211-5

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

495-8

issue

4

eissn

0174-1551

issn

1432-086X

journal_volume

28

pub_type

杂志文章

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