Endovascular Management of a Refractory Pseudoaneurysm of the Sternocleidomastoid Artery Caused by Attempted Internal Jugular Central Line Placement with Long-Term Follow-Up: A Case Report and Review.

Autor: Abdel-Aty Y; Mayo Clinic Arizona, Department of Otolaryngology Head and Neck Surgery, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA., Bellew MP; Department of Medical Education, Assistant Professor of Neurosurgery, UCF College of Medicine, 6850 Lake Nona Blvd, Orlando, FL 32827, USA.; Florida Hospital Orlando, 601 East Rollins Street, Orlando, FL 32803, USA.
Jazyk: angličtina
Zdroj: Case reports in otolaryngology [Case Rep Otolaryngol] 2018 Oct 10; Vol. 2018, pp. 8324908. Date of Electronic Publication: 2018 Oct 10 (Print Publication: 2018).
DOI: 10.1155/2018/8324908
Abstrakt: Introduction: This case report shows successful treatment of a refractory sternocleidomastoid branch of the superior thyroid artery (SBSTA) pseudoaneurysm using endovascular glue embolization in a patient who refused surgery.
Case Presentation: A 63-year-old female with multiple comorbidities presented with a firm 7 cm tender mass located in the right neck. Ultrasound showed pseudoaneurysm and a 7 × 3.3 × 4 cm multilobular hematoma in the location of the previous central line. CTA showed a corresponding heterogeneous mass. Serial imaging demonstrated enlargement over 2 weeks. Angiogram showed contrast blush off of the SBSTA.
Management and Outcome: SBSTA was embolized using glue. Repeat angiogram showed embolization and no contrast blush. One month later, the mass was no longer pulsatile but present on physical exam. CTA showed decreased size. 8 months later, her neck was soft without mass.
Discussion: Pseudoaneurysms of the external carotid artery are rare and usually due to trauma. Pseudoaneurysms after central line placement are documented, but most are complications of femoral central lines. A handful of cases of superior thyroid artery pseudoaneurysms due to several etiologies are reported, but none involving the SBSTA. Therapeutic options include surveillance, compression, thrombin injection, embolization, and surgery. Endovascular management offers an alternative for patients unwilling or unable to undergo open surgery.
Databáze: MEDLINE
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