Ruptured pseudoaneurysm of the internal maxillary artery complicating CT-guided fine-needle aspiration in an irradiated, surgical bed.
BACKGROUND
CT-guided fine-needle aspiration (FNA) is a safe procedure, but major complications can occur rarely. Pseudoaneurysm rupture in the head and neck region following CT-guided FNA is an emergency that can result in life-threatening hemorrhage. This case emphasizes the salient risk factors for pseudoaneurysm formation and rupture in the head and neck region following CT-guided FNA.


METHODS
A patient was seen with oral and facial hemorrhage as a result of a ruptured pseudoaneurysm 11 weeks following CT-guided FNA in a previously irradiated surgical bed.


RESULTS
The patient was treated with coil embolization in and around the pseudoaneurysm and discharged without any further complications.


CONCLUSIONS
Although CT-guided FNA is a safe and effective procedure, some patients may be at increased risk for rare but major complications. Caution should be used in proceeding with CT-guided FNA in an irradiated surgical bed of the head and neck.
Oh
John C
JC
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Weber
Randal S
RS
Bagley
Linda J
LJ
Loevner
Laurie A
LA
D017541:Aneurysm, False / Q000209:etiology* / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy; D044963:Biopsy, Fine-Needle; D004621:Embolization, Therapeutic; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008438:Maxillary Artery; D008545:Melanoma / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D015641:Radiography, Interventional; D011878:Radiotherapy / Q000009:adverse effects; D012421:Rupture / Q000628:therapy; D012888:Skull Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D013284:Stomatognathic System / Q000473:pathology*; D013701:Temporal Bone / Q000528:radiation effects / Q000601:surgery; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000528:radiation effects / Q000601:surgery