Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
J Neurointerv Surg. 2018 Jul;10(7):e18. doi: 10.1136/neurintsurg-2017-013178.rep. Epub 2018 Apr 7.
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）是头颈部手术已知的破坏性并发症。在放射治疗、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 的治疗选择是结扎出血动脉；然而，最近，血管内闭塞已成为更常见的选择。如果存在假性动脉瘤，则治疗包括用血管内线圈进行夹闭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的情况。本报告介绍了一位 57 岁女性的病例，她在经历了一次急性呼吸窘迫发作后到耳鼻喉科就诊，当她从气管造口管咳出栓塞线圈材料时，呼吸窘迫得到缓解。在发作前三个月，她因危及生命的出血而行颈外动脉假性动脉瘤线圈栓塞治疗。
