Selective transarterial embolization for arterial hemorrhage after upper third molar extraction: illustrative cases.

Autor:	Tokuyama K; Departments of1Radiology and., Kiyosue H; 2Department of Diagnostic Radiology, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan; and., Shimada R; Departments of1Radiology and., Miyamoto S; 4Department of Radiology, Hamanomachi Hospital, Fukuoka, Japan., Abe A; 3Oral and Maxillofacial Surgery, Oita University Faculty of Medicine, Yufu City, Oita, Japan., Kawano K; 3Oral and Maxillofacial Surgery, Oita University Faculty of Medicine, Yufu City, Oita, Japan., Asayama Y; Departments of1Radiology and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Jul 24; Vol. 6 (4). Date of Electronic Publication: 2023 Jul 24 (Print Publication: 2023).
DOI:	10.3171/CASE23118
Abstrakt:	Background: The present report describes 2 cases of arterial bleeding after removal of the upper third molar that were successfully treated with selective transarterial embolization. Observations: The first patient underwent removal of the left upper third molar. A few hours later, facial swelling and massive bleeding appeared near the extraction socket involving the posterolateral wall of the maxillary sinus. Angiography showed a pseudoaneurysm involving the posterior superior dental artery, and the lesion was selectively embolized with an N-butyl cyanoacrylate (NBCA)-lipidiol mixture. The second patient underwent removal of the left upper third molar, and massive bleeding occurred from the extraction socket involving the greater palatine foramen. Angiography revealed the pseudoaneurysm of the greater palatine artery, and the lesion was selectively embolized with an NBCA-lipiodol mixture. Both patients were discharged uneventfully, and no recurrent bleeding was observed during the 82- and 5-month follow-up periods. Lessons: Massive arterial bleeding after a third molar extraction occurs from either the posterior superior dental artery or the greater palatine artery, which is associated with the location of the extraction socket. Selective transarterial glue embolization is a useful option for the treatment of arterial bleeding after the removal of the upper third molars.
Databáze:	MEDLINE
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