title: Endovascular management of postoperative pseudoaneurysms of the external carotid artery.
abstract: Hemorrhage secondary to postoperative pseudoaneurysm is a rare event, but may complicate the clinical course of straightforward and common interventions such as sinonasal procedures, tonsillectomy, and maxillofacial and plastic surgeries. We report our experience with the endovascular management of iatrogenic pseudoaneurysm in eight patients who had undergone recent craniomaxillofacial surgery. Computed tomography (CT), including CT-angiography, detected only three of the eight lesions. In all patients, endovascular embolization achieved successful occlusion of the pseudoaneurysm without local or general procedure-related complications. Immediate proximal arterial occlusion with detachable coils was performed in every case, and pseudoaneurysm coiling was performed in three cases presenting with active hemorrhage. Endovascular therapy proved to be safe and effective in the management of postoperative pseudoaneurysms. Surgeons involved in the craniomaxillofacial procedures should be aware of this complication and its management.
authors.affiliation: Department of Neurosurgery, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem, 91120, Israel. jcohenns@yahoo.com
authors.forename: José E
authors.initials: JE
authors.lastname: Cohen
authors.forename: John M
authors.initials: JM
authors.lastname: Gomori
authors.forename: Samuel
authors.initials: S
authors.lastname: Moscovici
authors.forename: Savvas
authors.initials: S
authors.lastname: Grigoriadis
authors.forename: Fernando
authors.initials: F
authors.lastname: Ramirez de Noriega
authors.forename: Eyal
authors.initials: E
authors.lastname: Itshayek
mesh_terms: D000293:Adolescent; D000328:Adult; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011859:Radiography; D055815:Young Adult