Role of CT angiography and embolisation in the management of life-threatening haemorrhage following microvascular head and neck reconstruction.
Post-operative haemorrhage in the head and neck cancer patient can have a catastrophic outcome either for the patient or the free flap if microvascular reconstruction has been performed. The life of the patient always takes priority over the flap; however the pedicle can be at risk when the patient is returned to theatre for arrest of the haemorrhage. CT angiography is a good non-invasive method of determining the source of bleeding and facilitating superselective embolisation, minimizing risk to the flap pedicle. We present a case which this treatment was successfully used with a good result and would recommend its use when similar situations occur.
Wylie
Jennifer
J
York District Hospital, Wigginton Road, York YO31 8HE, United Kingdom. wylie517@btinternet.com
Knepil
Gregor J
GJ
Warnock
Niall
N
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000792:Angiography / Q000295:instrumentation / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008438:Maxillary Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008866:Microsurgery; D055806:Microvessels / Q000601:surgery; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000628:therapy*; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D013524:Surgical Flaps / Q000098:blood supply; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome