Korean J Radiol.  2010 Dec;11(6):603-611. 10.3348/kjr.2010.11.6.603.

Endovascular Treatment of Traumatic Pseudoaneurysm Presenting as Intractable Epistaxis

Affiliations
  • 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China. zcwazq@sina.com

Abstract


OBJECTIVE
To investigate the clinical efficacy of individual endovascular management for the treatment of different traumatic pseudoaneurysms presenting as intractable epistaxis.
MATERIALS AND METHODS
For 14 consecutive patients with traumatic pseudoaneurysm presenting as refractory epistaxes, 15 endovascular procedures were performed. Digital subtraction angiography revealed that the pseudoaneurysms originated from the internal maxillary artery in eight patients; and all were treated with occlusion of the feeding artery. In six cases, they originated from the internal carotid artery (ICA); out of which, two were managed with detachable balloons, two with covered stents, one by means of cavity embolization, and the remaining one with parent artery occlusion. All of these cases were followed up clinically from six to 18 months, with a mean follow up time of ten months; moreover, three cases were also followed with angiography.
RESULTS
Complete cessation of bleeding was achieved in all the 15 instances (100%) immediately after the endovascular therapies. Of the six patients who suffered from ICA pseudoaneurysms, one presented with a permanent stroke and one had an episode of rebleeding requiring intervention.
CONCLUSION
In patients presenting with a history of craniocerebral trauma, traumatic pseudoaneurysm must be considered as a differential diagnosis. Individual endovascular treatment is a relatively safe, plausible, and reliable means of managing traumatic pseudoaneurysms.

Keyword

Traumatic; Pseudoaneurysm; Epistaxis; Endovascular therapy
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