title: External carotid artery pseudoaneurysm following microvascular free flap reconstruction. The role of endovascular thrombin injection in embolization: a case report and review.
abstract: Pseudoaneurysm at the anastomosis of the free flap following ablative head and neck surgery is uncommon. We present a case of external carotid artery pseudoaneurysm in a patient who had previously undergone a subtotal glossectomy, neck dissection, and radial forearm free flap reconstruction. The traditional treatment for pseudoaneurysm has been open surgical repair. Our patient underwent successful treatment with an endovascular embolization utilizing thrombin injection of the aneurysmal sac. This case highlights the role of interventional radiology in the management of this rare but important complication of microvascular reconstructive surgery.
authors.affiliation: Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK. Electronic address: drshafiqislam@hotmail.co.uk.
authors.forename: S
authors.initials: S
authors.lastname: Islam
authors.affiliation: Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ali
authors.affiliation: Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK.
authors.forename: C
authors.initials: C
authors.lastname: Avery
authors.affiliation: Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Hayter
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002342:Carotid Artery, External; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D005542:Forearm / Q000098:blood supply; D058752:Free Tissue Flaps / Q000098:blood supply*; D005927:Glossectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D013917:Thrombin / Q000627:therapeutic use*; D014062:Tongue Neoplasms / Q000601:surgery*
chemical_list: D013917:Thrombin
keywords: endovascular; external carotid artery; free flap; management; oral cancer; pseudoaneurysm; radical surgery; thrombin injection