Department of Neurosurgery, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem, 91120, Israel.
J Clin Neurosci. 2012 May;19(5):649-54. doi: 10.1016/j.jocn.2011.11.007.
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.
术后假性动脉瘤出血是一种罕见的事件，但可能会使常规的常见干预措施（如鼻-鼻窦手术、扁桃体切除术、颌面和整形手术）的临床过程复杂化。我们报告了在最近接受颅颌面手术后的 8 例患者中，对医源性假性动脉瘤进行血管内治疗的经验。计算机断层扫描（CT），包括 CT 血管造影，仅检测到 8 个病变中的 3 个。在所有患者中，血管内栓塞均成功地闭塞了假性动脉瘤，没有出现局部或与全身相关的手术并发症。在每个病例中都进行了近端动脉即刻闭塞和可解脱的线圈栓塞，对于有活动性出血的 3 个病例则进行了假性动脉瘤栓塞。血管内治疗在假性动脉瘤的治疗中被证明是安全有效的。涉及颅颌面手术的外科医生应该意识到这种并发症及其处理方法。
