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Ray N, Ahuja CK, Kumar A, Panda N, Singh P. Post-Tracheostomy Vascular Injury to the Anomalous Thymic Branch Managed by Endovascular Coiling. Vasc Endovascular Surg 2021; 56:208-211. [PMID: 34622722 DOI: 10.1177/15385744211051504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tracheostomy-related arterial haemorrhage can be devastating especially if arising from an obscure anomalous vessel which can potentially complicate treatment decision. METHODS We report a case of non-Hodgkin's lymphoma with upper airway obstruction, who had profuse bleeding, post-tracheostomy, from the stomal site. CT angiography showed presence of a pseudoaneurysm adjacent to the tracheostomy site which was confirmed on catheter angiography to be arising from anomalous thymic branch of right common carotid artery (CCA). Superselective cannulation of the anomalous thymic artery was done using a microcatheter with subsequent coil embolization. RESULTS Post-coiling, the bleeding stopped immediately and the patient recovered. He was under oncology care till 3 months following embolization and was doing well. CONCLUSIONS The emergency physicians should be aware of this rare variation of thymic artery while performing tracheostomy. Ultrasound as point-of-care device may help mitigate these complications. Endovascular embolization is a minimally invasive and effective management option for an injured arterial branch from a tracheostomy.
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Affiliation(s)
- Nirmalya Ray
- Division of Neuroradiology, Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Chirag Kamal Ahuja
- Division of Neuroradiology, Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ajay Kumar
- Division of Neuroradiology, Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Naresh Panda
- Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Paramjeet Singh
- Division of Neuroradiology, Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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2
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Zhang N, Lechien JR, Martinez V, Carlier RY, El Hajjam M. Contribution of Interventional Radiologist in the Management of Pseudoaneurysm and Neck Hemorrhages in COVID-19 patients. EAR, NOSE & THROAT JOURNAL 2021; 100:148S-151S. [PMID: 33410706 DOI: 10.1177/0145561320987030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with severe coronavirus disease 2019 (COVID-19) may have endothelial inflammation, pseudoaneurysm, and an increasing risk of bleeding, especially during surgical procedures. In this article, we reported 2 cases of COVID-19 patients with neck vascular lesions. The first patient had pseudoaneurysm of the cricothyroid artery, which was treated by percutaneous glue injection through ultrasonography guidance. The second patient presented lateral neck hematoma in front of the left superior thyroid artery, which was managed by coil endovascular embolization. In the context of pandemic, the management of vascular lesions may be performed through interventional radiological procedures that may reduce the risk of virus aerosolization and health care provider contamination.
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Affiliation(s)
- Norbert Zhang
- Department of Medical Imaging and Interventional Radiology, DMU Smart Imaging. 26930Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - Jérôme R Lechien
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, GH Université Paris-Saclay, Suresnes, France
| | - Valéria Martinez
- Department of Anesthesiology, 26930Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Hospital, Garches, France
| | - Robert-Yves Carlier
- Department of Medical Imaging and Interventional Radiology, DMU Smart Imaging, 26930Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Hospital, Garches, France
| | - Mostafa El Hajjam
- Department of Medical Imaging and Interventional Radiology, DMU Smart Imaging. 26930Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Ambroise Paré Hospital, Boulogne-Billancourt, France
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3
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Rasteau S, Bonnet L, Jay-Caillierez L, Eker O, Joffredo E, Allaouchiche B, Sigaux N. Spontaneous rupture of an aneurysm of the superior thyroid artery: A rare cause of acute respiratory failure. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 123:88-90. [PMID: 33346143 DOI: 10.1016/j.jormas.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 11/19/2022]
Abstract
Ruptured aneurysm of superior thyroid artery is a very rare pathological event. Underlying causes such as trauma, malignancy or iatrogenic are not systematically found. Resulting cervical hematoma is life threatening and can lead to acute respiratory failure, dysphagia, vocal cord paralysis and hemomediastinum. Endovascular treatment combined with surgical drainage has been described as an effective treatment. In this case report, a 63-year-old man presented a spontaneous rupture of an aneurysm of superior thyroid artery resulting in cervical hematoma and acute respiratory failure.
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Affiliation(s)
- Simon Rasteau
- Department of Maxillofacial Surgery, Stomatology and Facial Plastic Surgery, Claude-Bernard Lyon 1 University - Hospices Civils de Lyon, Lyon Sud Hospital, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France.
| | - Laura Bonnet
- Emergency Department - Lucien Husset Vienne Hospital - Montée Dr Maurice Chapuis, 38200 Vienne, France
| | - Lucille Jay-Caillierez
- Intensive Care and Anesthesiology Department - Hospices Civils de Lyon, Lyon Sud Hospital, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - Omer Eker
- Department of Neuroradiology - Hospices Civils de Lyon, Pierre Wertheimer Hospital, 59 Boulevard Pinel, 69500, Bron, France
| | - Emilie Joffredo
- Intensive Care and Anesthesiology Department - Hospices Civils de Lyon, Lyon Sud Hospital, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - Bernard Allaouchiche
- Intensive Care and Anesthesiology Department - Hospices Civils de Lyon, Lyon Sud Hospital, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - Nicolas Sigaux
- Department of Maxillofacial Surgery, Stomatology and Facial Plastic Surgery, Claude-Bernard Lyon 1 University - Hospices Civils de Lyon, Lyon Sud Hospital, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
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4
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Tian S, Tian G, Jiang T. Pseudoaneurysm of superior thyroid artery following ultrasound-guided radiofrequency ablation of hyperplastic parathyroid gland: a case report and literature review. Quant Imaging Med Surg 2020; 10:1162-1168. [PMID: 32489940 PMCID: PMC7242314 DOI: 10.21037/qims.2020.03.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 02/26/2020] [Indexed: 12/09/2023]
Affiliation(s)
- Shuyuan Tian
- Department of Ultrasound, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
| | - Guo Tian
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310006, China
| | - Tianan Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310006, China
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Agyei JO, Alvarez C, Iqbal A, Fanous AA, Siddiqui AH. Successful Kissing Balloon Expandable Stent Graft Treatment for a Right Common Carotid Pseudoaneurysm Caused by Tracheotomy. World Neurosurg 2018; 114:241-244. [PMID: 29602007 DOI: 10.1016/j.wneu.2018.03.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND A rare complication following tracheotomy is common carotid artery (CCA) pseudoaneurysm. Treatment modalities for CCA pseudoaneurysm include surgical repair and single-artery balloon-covered stent graft technique. We describe successful treatment of tracheotomy-related CCA pseudoaneurysm with the "kissing balloon" expandable stent graft technique. CASE DESCRIPTION We successfully implemented the kissing balloon expandable stent graft technique for treatment of a large, narrow-necked, bilobed CCA pseudoaneurysm that arose owing to a tracheotomy complication. The pseudoaneurysm was detected while performing a diagnostic angiogram of the aortic arch and surrounding vessels. The stent was deployed while the 2 balloons were introduced in a kissing manner such that they faced one another to avoid occlusion of either branch of the innominate artery coming into contact; 1 balloon was inflated at the origin of the right subclavian artery, and the other was inflated at the right innominate artery simultaneously. The pseudoaneurysm was successfully contained; normal blood flow was restored in the CCA. The balloons were deflated and withdrawn. The patient remained neurologically intact after the procedure. CONCLUSIONS The kissing balloon technique is a safe and effective alternative to surgical repair, as it prevents morbidities associated with the surgical procedure. Also, this technique decreases the risk of major side-branch occlusion associated with the single-artery balloon-covered stent graft technique.
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Affiliation(s)
- Justice O Agyei
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Cynthia Alvarez
- Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA
| | - Azher Iqbal
- Department of Vascular and Interventional Radiology, Buffalo General Medical Center at Kaleida Health, Buffalo, New York, USA
| | - Andrew A Fanous
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Adnan H Siddiqui
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA; Department of Radiology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Department of Vascular and Interventional Radiology, Buffalo General Medical Center at Kaleida Health, Buffalo, New York, USA; Canon Stroke and Vascular Research Center at the University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo, New York, USA.
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Tanaka K, Tachibana N, Sato H, Uematsu K, Shiba Y, Hamami G. Profuse bleeding from a pseudoaneurysm of the right superior thyroid artery after tracheostomy. Acute Med Surg 2015; 3:199-203. [PMID: 29123783 DOI: 10.1002/ams2.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/05/2015] [Indexed: 11/10/2022] Open
Abstract
Case A 70-year-old man was brought to our hospital emergency department with accidental thermal burns. Surgical tracheostomy was carried out on day 8 after admission, followed by several profuse bleeding episodes from the orifice. Contrast-enhanced computed tomography of the neck revealed a small nodule with arterial phase enhancement that was suspected to be a pseudoaneurysm. During emergency angiography, the nodule was revealed to be a pseudoaneurysm arising from the right superior thyroid artery with contrast medium extravasation. Outcome The patient underwent transcatheter arterial embolization, which resolved bleeding from the tracheostomy orifice. Conclusion Pseudoaneurysm of the superior thyroid artery is an extremely rare and life-threatening tracheostomy complication. All clinicians certified to perform tracheostomy should be acquainted with the various complications and methods for managing life-threatening post-tracheostomy complications.
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Affiliation(s)
- Koichi Tanaka
- Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
| | - Naoto Tachibana
- Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
| | - Hirokazu Sato
- Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
| | - Keigo Uematsu
- Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
| | - Yosuke Shiba
- Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
| | - Gen Hamami
- Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
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Lee SH, Choi HJ, Yang JS, Cho YJ. Coil embolization in ruptured inferior thyroid artery aneurysm with active bleeding. J Korean Neurosurg Soc 2014; 56:353-5. [PMID: 25371788 PMCID: PMC4219196 DOI: 10.3340/jkns.2014.56.4.353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 06/23/2014] [Accepted: 08/06/2014] [Indexed: 11/27/2022] Open
Abstract
We present a unique experience of urgent parent arterial embolization for treatment of an aneurysm of the inferior thyroid artery (ITA) that bled during tracheostomy. The event happened to a 69-year-old female patient with subarachnoid hemorrhage and hospital-acquired pneumonia that required tracheostomy. Abrupt and massive bleeding developed during the procedure, and the source could not be identified. Under manual compression, angiography revealed an 8-mm aneurysm that arose from the inferior thyroid artery. The superselected parent artery of the aneurysm was successfully occluded with a single pushable coil. The patient's postoperative course was uneventful.
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Affiliation(s)
- Sung Ho Lee
- Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyuk Jai Choi
- Department of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jin Seo Yang
- Department of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Yong Jun Cho
- Department of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea
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