The Usefulness of Transcatheter Arterial Embolization for Panfacial Injury

Kim, Jae Woo; Choi, Hwan Jun; Kim, Mi Sun; Yang, Seung Boo

Abstract

PURPOSE: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures.
METHODS
A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam.
RESULTS
After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations.
CONCLUSION
Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.