Anastomosis, Surgical ; Carotid Artery Diseases ; surgery ; Carotid Artery, External ; transplantation ; Carotid Artery, Internal ; surgery ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Vascular Surgical Procedures ; methods

While oral and maxillofacial surgery such as orthognathic surgery, TMJ surgery is in progress, there always exists a risk of bleeding from maxillary artery, and this perplexes the surgeon in operation. In case of massive bleeding, it is mostly very difficult or even impossible to take an immediate action in order to stop bleeding. Even when hemostasis is possible by applying such methods as the use of local hemostatics, pressing, electrocoagulation or direct ligation, there is a high risk of secondary bleeding. Therefore, in case there is bleeding from maxillary artery, it is the best to restrain bleeding completely either by the ligation of the artery in bleeding in operation fields or by the ligation of the external carotid artery.
Arteries ; Carotid Artery, External ; Electrocoagulation ; Hemorrhage* ; Hemostasis ; Hemostatics ; Ligation ; Maxillary Artery ; Orthognathic Surgery ; Surgery, Oral ; Temporomandibular Joint

Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.
Adult ; Arterial Occlusive Diseases/radiography ; Carotid Artery, External/*abnormalities/radiography/surgery ; Carotid Artery, Internal/*abnormalities/radiography/surgery ; Cerebral Angiography ; Humans ; Intracranial Aneurysm/*radiography/surgery ; Male ; Middle Aged

We report a new approach of embolization in a 15-year-old boy that presented with a massive hemorrhage from a maxillary arteriovenous malformation. Re-bleeding occurred after emergent ligation of the external carotid artery. The bleeding was successfully controlled by embolization via the superficial temporal artery.
Adolescent ; Arteriovenous Malformations/*therapy ; Carotid Artery, External/surgery ; Embolization, Therapeutic/*methods ; Hemorrhage/etiology/therapy ; Humans ; Ligation ; Male ; Maxillary Artery/*abnormalities ; Temporal Arteries

OBJECTIVETo introduce the method of retrograde embolization through the superficial temporal artery (STA) after the ligation of external carotid artery (ECA) for the treatment of craniofacial arterio-venous malformations (AVM).

METHODSSeven cases of craniofacial AVM were included in the study. After the ligation of ECA, the STA was surgically accessed and a 4F (1F = 0.333 mm) sheath introduced into the artery, and N-butyl-2-cyanoacrylate (NBCA) was selected as the permanent embolization material.

RESULTSThe angiogram was successfully carried out in these cases, which showed that some collateral branches from the ophthalmic artery of left internal carotid artery, vertebral artery and thyrocervical trunk provided the blood supply to the AVM nidus. The retrograde embolization with NBCA was completed.

CONCLUSIONSThe vascular architecture of craniofacial AVM after the ligated ECA was better demonstrated in angiogram of vertebral artery. The retrograde embolization through STA was an effective method for the treatment of craniofacial AVM.

Adolescent ; Adult ; Arteriovenous Malformations ; therapy ; Carotid Artery, External ; surgery ; Embolization, Therapeutic ; Face ; blood supply ; Female ; Humans ; Ligation ; adverse effects ; Male ; Middle Aged ; Young Adult

OBJECTIVETo explore the difference of lingual arterial CT angiography images(CTA) between obstructive sleep apnea hypopnea syndrome (OSAHS) patients and normal subjects, and to investigate the safety of partial glossectomy guided by lingual arteria CT angiography.

METHODSSeventy-four patients with OSAHS and 10 control adults were included in the study. The lingual upper airway and lingual arterial CT angiography were obtained. The area and the dimensions of lingual upper airway, and the length and thickness of lingua, length of lingual arteria, depth and bilateral lingual arteria spacing were studied. The CT measuring data of OSAHS patients and normal adults were compared. The multinomial logistic regression analysis was used to investigate the main factors which affects the lingual arterial measuring results. Guided by the lingual arterial CT angiography and measuring results, glossectomy was performed in 23 OSAHS patients with lingua hypertrophy.

RESULTSThe area and dimensions of lingual airway of OSAHS patients were less than those of control adults, and the length and thickness of lingua of OSAHS were more than those of control adults (t test, P < 0.05 or P < 0.01). There were no difference in length of lingual arteria and bilateral lingual arteria spacing between OSAHS patients and control adults. The 3 measured points' depth (x(-) +/- s) of lingual arteria of OSAHS patients were (29.1 +/- 5.5) mm, (26.9 +/- 5.1) mm and (25.6 +/- 5.2) mm, respectively, and those of control adult were (23.0 +/- 3.8) mm, (22.6 +/- 2.7) mm and (21.5 +/- 2.6) mm, the depth of lingual arteria of OSAHS was more than that of control adults (t test, P < 0.05 or P < 0.01). The main factors affects lingual arterial depth were body mass index (BMI), lingual length and lingual thickness, unstandardized regression coefficient were 0.255, 0.11 and 0.03, respectively (analysis of variance, F = 6.216, P < 0.05). No damage of lingual arteria and nerve in 23 patients who had expanded glossectomy.

CONCLUSIONSThe study showed statistical difference significance of lingual arterial CTA measurements between OSAHS patients and control adults. Guided with lingual arteria CTA data, the expanded glossectomy in OSAHS patients has proved good safety and high cure rate.

Adult ; Angiography ; Carotid Artery, External ; diagnostic imaging ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Tongue ; blood supply ; surgery ; Young Adult