Ulus Travma Acil Cerrahi Derg. 2017; 23(5): 433-437 | DOI: 10.5505/tjtes.2017.55560

Emergency endovascular treatment of a ruptured external carotid artery pseudoaneurysm caused by a cervical stab wound: A case report and literature review

Junya Tsurukiri¹, Eitaro Okumura¹, Hiroshi Yamanaka¹, Hiroyuki Jimbo², Akira Hoshiai^1
1Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo-Japan
²Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, Tokyo-Japan

The formation of external carotid artery (ECA) pseudoaneurysms caused by stab wounds is a rare vascular anomaly. Although the surgical exploration of the ECA segment is the standard treatment, endovascular treatment (EVT) can be considered if there is difficulty in identifying the source of bleeding in the injured regions that are difficult to operatively access. Here we treated a young patient who had hemorrhagic instability with hemorrhage-induced coagulopathy caused by a zone III cervical stab wound with a pseudoaneurysm from the main trunk of the ECA; the patient underwent EVT and successful hemostasis. A literature review based on the data available on PubMed was conducted, and 15 published reports of 82 penetrating ECA injuries treated by EVT were identified. We concluded that EVT appears to be an effective surgical alternative for patients with hemorrhage-induced coagulopathy caused by a ruptured ECA pseudoaneurysm after a cervical stab wound.

Keywords: Bleeding, injury, interventional radiology, penetrating, shock.

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Servikal penetran yaranýn neden olduðu eksternal karotis arter psödoanevrizmasý rüptürünün acil endovasküler tedavisi: Bir olgu sunumu ve literatürün gözden geçirilmesi

Junya Tsurukiri¹, Eitaro Okumura¹, Hiroshi Yamanaka¹, Hiroyuki Jimbo², Akira Hoshiai^1
1Tokyo Týp Üniversitesi Hachioji Týp Merkezi, Acil ve Kritik Bakým Kliniði, Tokyo-Japonya
²Tokyo Týp Üniversitesi Hachioji Týp Merkezi, Nöroþirurji Kliniði, Tokyo-Japonya

Penetran yaralanmanýn neden olduðu eksternal karotis arter (EKA) psödoanevrizmalarý seyrek görülen bir vasküler anomalidir. Eksternal karotis arter segmentinin eksplorasyonu standart tedavi olmasýna raðmen, cerrahi olarak ulaþýlmasý zor alanda kanamanýn kaynaðýný bulmada zorluk varsa endovasküler tedavi (EVT) düþünülebilir. Burada EKA’nýn ana gövdesinde psödoanevrizmalý III. zon boyun penetran yarasýnýn neden olduðu kanamanýn neden olduðu koagülopatiyle birlikte kanamasý durdurulamayan genç bir hastayý tedavi ettik. Hasta baþarýlý hemostazýn saðlandýðý EVT geçirmiþtir. PubMed verilerine dayanan literatür derlemeleri sonucu EVT ile tedavi edilmiþ penetran EKA yaralanmalarýna ait 155 yayýnlanmýþ olgu raporu saptanmýþtýr. Endovasküler tedavinin, boyunda penetran yaralanma sonrasý oluþan rüptüre EKA psödoanevrizmasýnýn yol açtýðý kanamanýn neden olduðu koagülopati hastalarýnda etkili bir alternatif cerrahi tedavi olduðu kararýna vardýk.

Anahtar Kelimeler: Boyun, giriþimsel radyoloji, kanama, penetran, silahla yaralanma, þok, yaralanma.

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