Endovascular Treatment to Stop Life-threatening Bleeding from Branches of the External Carotid Artery in Patients with Traumatic Maxillofacial Fracture.
10.7461/jcen.2016.18.2.83
- Author:
Woosung LEE
1
;
Yu Shik SHIM
;
Joonho CHUNG
Author Information
1. Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ns.joonho.chung@gmail.com
- Publication Type:Original Article
- Keywords:
Endovascular procedures;
Facial bones;
Hemorrhage;
Maxillary artery;
Maxillary fractures
- MeSH:
Accidental Falls;
Accidents, Traffic;
Blood Pressure;
Body Temperature;
Carotid Artery, External*;
Endovascular Procedures;
Erythrocytes;
Facial Bones;
Follow-Up Studies;
Glasgow Coma Scale;
Groin;
Hemorrhage*;
Humans;
Maxillary Artery;
Maxillary Fractures;
Plasma;
Punctures
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2016;18(2):83-89
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures. MATERIALS AND METHODS: A total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria: 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding. Various clinical factors were recorded for each patient and the correlations between those factors and clinical outcome (Glasgow Outcome Scale, GOS) were evaluated. RESULTS: Four patients were injured in traffic accidents, five in falls, and three by assaults. Mean initial Glasgow Coma Scale (GCS) was 6.9 ± 2.1 and the lowest hemoglobin measured was mean 6.3 ± 0.9 g/dL. GOS at discharge was 4 in five patients, 3 in three patients, and 1 (death) in four patients. GOS on follow-up (mean 13.7 months) was 5 in two patients, 4 in three patients, and 3 in three patients. Initial GCS (p = 0.016), lowest systolic blood pressure (p = 0.011), and lowest body temperature (p = 0.012) showed a significant positive correlation with good clinical outcomes. The number of units of red blood cells transfused (p = 0.030), the number of units of fresh frozen plasma transfused (p = 0.013), and the time from arrival to groin puncture (p < 0.001) showed significant negative correlation with good clinical outcomes. CONCLUSION: It might be suggested that rapid transition to EVT could be preferable to struggling with other rescue strategies to stop life-threatening bleeding from branches of the ECA in patients with traumatic maxillofacial fractures.
