Transarterial embolization of acute external carotid blowout syndrome with profuse oronasal bleeding by N-butyl-cyanoacrylate.
OBJECTIVE
Assess duration, efficacy, and safety of emergent transarterial embolization of acute external carotid blowout syndrome (ECBS) with N-butyl-cyanoacrylate.


METHODS
Medical records were reviewed for 16 patients (15 men, 1 woman; age range, 28-85 years) who had 17 acute ECBS events that presented with profuse transoronasal bleeding. Predisposing factors were carcinoma associated with surgery and/or radiotherapy (n = 14) or trauma (n = 3). Affected arteries were the internal maxillary artery (n = 5), superior thyroid artery (n = 4), lingual artery (n = 4), facial artery (n = 2), or ascending pharyngeal artery (n = 2).


RESULTS
Endovascular treatment successfully obliterated all acute ECBSs with cessation of profuse hemorrhage. Mean duration of procedure was 54 minutes. Three patients had recurrent carotid blowout syndrome events, with 1 resulting death. Clinical follow-up range was 2 to 23 months.


CONCLUSIONS
Transarterial N-butyl-cyanoacrylate embolization can successfully manage acute ECBS with profuse hemorrhage. The technique is both efficient and safe, and the procedure can be rapidly completed.
Luo
Chao-Bao
CB
Department of Radiology, Taipei Veterans General Hospital and School of Medicine, National Yang Ming University, Taipei 112, Taiwan, ROC. cbluo@vghtpe.gov.tw
Teng
Michael Mu-Huo
MM
Chang
Feng-Chi
FC
Chang
Cheng-Yen
CY
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002340:Carotid Artery Diseases / Q000150:complications* / Q000628:therapy*; D020212:Carotid Artery Injuries / Q000150:complications* / Q000628:therapy*; D002342:Carotid Artery, External; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D004844:Epistaxis / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture; D013577:Syndrome; D016896:Treatment Outcome
D003487:Cyanoacrylates