Wilseck Zachary, Savastano Luis, Chaudhary Neeraj, Pandey Aditya S, Griauzde Julius, Sankaran Sumanna, Wilkinson D Andrew, Gemmete Joseph J
Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
BMJ Case Rep. 2017 Aug 29;2017:bcr-2017-013178. doi: 10.1136/bcr-2017-013178.
Carotid blowout syndrome (CBS) is a known devastating complication of head and neck surgery. The risk of developing CBS increases in the setting of radiation therapy, wound breakdown, or tumor recurrence. Traditionally, the treatment of choice for CBS is surgical ligation of the bleeding artery; however, recently, endovascular occlusion has become a more common option. If a pseudoaneurysm is present, treatment consists of trapping with endovascular coils or occlusion with a liquid embolic agent. Delayed migration of embolization coils into the airway causing acute respiratory distress is a rare occurrence. This report presents a case of a 57-year-old woman who presented to her otolaryngologist after experiencing an episode of acute respiratory distress which resolved when she expectorated embolization coil material from her tracheostomy tube. Three months prior to the episode she underwent coil embolization of an external carotid artery pseudoaneurysm for life-threatening hemorrhage.
颈动脉破裂综合征（CBS）是头颈外科手术中一种已知的严重并发症。在接受放射治疗、伤口破裂或肿瘤复发的情况下，发生CBS的风险会增加。传统上，CBS的首选治疗方法是对出血动脉进行手术结扎；然而，近来血管内闭塞已成为更常用的选择。如果存在假性动脉瘤，治疗方法包括用血管内线圈进行圈套或用液体栓塞剂进行闭塞。栓塞线圈延迟迁移至气道导致急性呼吸窘迫是一种罕见情况。本报告介绍了一例57岁女性病例，该患者在经历一次急性呼吸窘迫发作后就诊于耳鼻喉科医生，当她从气管造口管咳出栓塞线圈材料后，呼吸窘迫症状缓解。在此次发作前三个月，她因危及生命的出血接受了颈外动脉假性动脉瘤的线圈栓塞治疗。
