Perrucci Luca, Graziano Monica, Ferrante Zairo, Salviato Elisabetta, Carnevale Aldo, Galeotti Roberto
1Department of Interventional and Diagnostic Radiology, Arcispedale Sant'Anna, Ferrara, Italy.
2Section of Diagnostic Imaging, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
Patient Saf Surg. 2020 May 6;14:19. doi: 10.1186/s13037-020-00244-8. eCollection 2020.
An intrathoracic bleeding from the thyrocervical branch is not common in blunt trauma, but an interventional radiologist should be aware of the risks in order to prevent complications.
A 30-year-old male presented with a right pneumo-haemothorax due to active bleeding revealed at contrast-enhanced CT, as a consequence of a fall occurred in the previous week. The patient was treated with endovascular embolisation in an angiographic room with coils placement, since the right thyrocervical artery was found to be supplying the pneumo-haemothorax. A radiculo-medullary branch rose from the thyrocervical trunk, impeding the proximal embolization with microparticles and needing selective isolation of the bleeding artery with the catheter to avoid spinal cord injuries. The treatment had a successful result and the following CT control showed signs of recovering, without any complication.
Our paper presents a rare contingency, warning the operator to bear in mind the presence of arteries feeding the spinal cord. This crucial detail precludes the use of microparticles embolisation to prevent neurologic sequelae, whereas the use of endovascular coils for embolization should be mandatory. Moreover, this case reminds that the post-traumatic bleeding deriving from a cervical trauma may also occur later.
钝性创伤中来自甲状腺颈干分支的胸腔内出血并不常见，但介入放射科医生应了解相关风险以预防并发症。
一名30岁男性因上周摔倒，在增强CT检查时发现因活动性出血导致右侧血气胸。由于发现右侧甲状腺颈动脉为血气胸供血，患者在血管造影室接受了血管内栓塞治疗，放置了弹簧圈。一条神经根髓支从甲状腺颈干发出，阻碍了用微粒进行近端栓塞，需要用导管对出血动脉进行选择性隔离以避免脊髓损伤。治疗取得成功，随后的CT检查显示有恢复迹象，无任何并发症。
我们的论文展示了一种罕见情况，提醒操作者要牢记存在为脊髓供血的动脉。这一关键细节排除了使用微粒栓塞以预防神经后遗症的可能性，而应强制使用血管内弹簧圈进行栓塞。此外，该病例提醒，颈部创伤后的创伤后出血也可能在后期发生。
