Huang Jia-Zheng, Lu Wei-Chen, Lee Bo-Ching
Departments of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Department of Oncology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
Case Rep Oncol Med. 2024 May 13;2024:7925511. doi: 10.1155/2024/7925511. eCollection 2024.
Delayed migration and exposure of embolic coils is a rare complication of endovascular therapy for carotid blowout syndrome. A 64-year-old man with recurrent tongue cancer noticed the presence of foreign body in the malignant wound on the right side of his neck. He had undergone transarterial embolization on his right vertebral artery, right common carotid artery (CCA), and internal carotid artery (ICA) for carotid blowout syndrome 1 month prior. On physical examination, exposed spring-like metallic coils were observed, covered in brownish granulation tissue, at the bottom of the malignant wound. Neck radiograph and computed tomography confirmed the extrusion and migration of the embolic coils. In this case, the patient was managed by transection of the exposed coils at the wound surface with close monitoring. Computed tomography angiography is essential for assessing the condition of the remaining embolic coils. In cases with thrombosed parent arteries, a conservative approach, like the transection of exposed coils, can be employed as part of the management strategy.
栓塞弹簧圈延迟迁移和外露是颈动脉破裂综合征血管内治疗的一种罕见并发症。一名64岁复发性舌癌男性患者注意到其颈部右侧恶性伤口内有异物。1个月前，他因颈动脉破裂综合征接受了右侧椎动脉、右侧颈总动脉和颈内动脉的经动脉栓塞术。体格检查发现，在恶性伤口底部有外露的弹簧状金属线圈，表面覆盖着褐色肉芽组织。颈部X线片和计算机断层扫描证实了栓塞弹簧圈的挤出和迁移。在该病例中，通过在伤口表面切断外露的弹簧圈并密切监测对患者进行处理。计算机断层扫描血管造影对于评估剩余栓塞弹簧圈的情况至关重要。在母动脉血栓形成的病例中，可采用保守方法，如切断外露弹簧圈，作为治疗策略的一部分。
