Endovascular Embolization of Traumatic Vessel Injury Using N-butyl Cyanoacrylate: A Case Series.

Autor: Morsi RZ; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Baskaran A; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Thind S; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Carrión-Penagos J; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Desai H; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Kothari SA; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Mirza M; Cerenovus (Johnson & Johnson), Galway Neuro Technology Center, Galway, Ireland., Lazaridis C; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Goldenberg F; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Hurley MC; Department of Radiology, University of Chicago, Chicago, IL USA., Mendelson SJ; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Prabhakaran S; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Zakrison T; Department of Surgery, University of Chicago, Chicago, IL USA., Mansour A; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA., Kass-Hout T; Department of Neurology, University of Chicago, 5841 S Maryland Ave., MC 2030, Chicago, IL USA.
Jazyk: angličtina
Zdroj: Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India [Indian J Otolaryngol Head Neck Surg] 2024 Apr; Vol. 76 (2), pp. 1554-1562. Date of Electronic Publication: 2023 Dec 08.
DOI: 10.1007/s12070-023-04357-1
Abstrakt: There is limited evidence of N-butyl cyanoacrylate (n-BCA) use in endovascular embolization of traumatic face and neck vessel injuries. We investigated the safety and effectiveness of n-BCA for this purpose. We retrospectively analyzed consecutive patients presenting to a Level 1 trauma center between April 2021 and July 2022. We included patients aged ≥ 18 years old with any vessel injury in the face and neck circulation requiring n-BCA embolization. The primary endpoint was n-BCA effectiveness defined as immediate control of active bleeding post-embolization. In total, 13 patients met the inclusion criteria. The median decade of life was 3 (IQR 3 - 5) with a male predominance (n = 11, 84.6%). Median Glasgow Coma Scale score on presentation was 15 (IQR 3-15). Eleven patients suffered gunshot wound injuries; two patients suffered blunt injuries. Injured vessels included facial artery (n = 6, 46.2%), buccal branch artery (n = 3, 23.1%), internal maxillary (n = 5, 38.5%), cervical internal carotid artery (n = 1, 7.7%), and vertebral artery (n = 1, 7.7%). All patients were treated with 1:2 n-BCA to ethiodol mixture with immediate extravasation control. No bleeding recurrence or need for retreatment occurred. One patient died in-hospital (7.7%). Patients were discharged to home (n = 8, 61.5%), day rehabilitation (n = 1, 7.7%), or acute rehabilitation (n = 3, 23.1%). One patient developed a right posterior cerebral artery infarct with hemorrhagic transformation. To our knowledge, this is the first study demonstrating the safety and effectiveness of n-BCA liquid embolism in traumatic vessel injuries, especially penetrating gunshot wounds.
Competing Interests: Conflict of interestThe authors declare no competing interests.
(© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
Databáze: MEDLINE
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