Endovascular management of exsanguinating vertebral artery transection.
BACKGROUND
Vertebral artery (VA) transection is a rarely described entity that may present dramatically with a life-threatening external hemorrhage.


METHODS
A 25-year-old man that was victim of a terrorist attack presented a gunshot wound to the mouth with massive bleeding. The bullet perforated the oropharynx and injured the right VA. Combined antegrade and retrograde endovascular embolization by means of detachable coils allowed rapid control of the bleeding.


CONCLUSIONS
Bleeding related to VA transection can be managed safely by means of endovascular combined approaches.
Cohen
José E
JE
Department of Neurosurgery, Section of Endovascular Neurosurgery and Interventional Neuroradiology, Hadassah Stroke Center, Hadassah University Hospital, Jerusalem, Israel 91120. jcohenns@yahoo.com
Rajz
Gustavo
G
Itshayek
Eyal
E
Umansky
Felix
F
Gomori
John M
JM
D000328:Adult; D020526:Brain Stem Infarctions / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D019736:Prostheses and Implants; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014711:Vertebral Artery / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*