Endovascular Embolization of Post-tonsillectomy Pseudoaneurysm: A Single-Center Case Series

• Published in: Cardiovascular and interventional radiology 2019-04, Vol.42 (4), p.528-533
• Main Authors: Hassan, F., Younes, A., Rifai, M.
• Format: Article
• Language: English
• Subjects: Aneurysm, False - etiology; Aneurysm, False - therapy; Arterial Interventions; Arteries; BIOMEDICAL RADIOGRAPHY; Bleeding; Cardiology; Cardiovascular system; CAROTID ARTERIES; Carotid artery; Child; Child, Preschool; CHILDREN; Clinical Investigation; Complications; Embolization; Embolization, Therapeutic - methods; Enbucrilate - therapeutic use; Female; HEMORRHAGE; Hemorrhage - etiology; Hemorrhage - therapy; Humans; Imaging; Infiltration; INJURIES; LIPIODOL; Male; Medicine; Medicine & Public Health; Motivation; Nuclear Medicine; PATIENTS; PHARYNX; Postoperative Complications - therapy; Pseudoaneurysm; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; SURGERY; Tonsillectomy - adverse effects; Treatment Outcome; Ultrasound; VASCULAR DISEASES
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-018-2131-9

Objective The aim of this study was to evaluate the efficacy and safety of endovascular embolization of post-tonsillectomy pseudoaneurysm with the usage of monomeric n -butyl-2-cyanoacrylate (NBCA) glue as a first intention. Methods We retrospectively analyzed the technical details and clinical outcome of ten consecutive children presented with delayed post-tonsillectomy bleeding, caused by lingual or facial artery pseudoaneurysm, which was treated by endovascular embolization. Results Seven patients had lingual artery pseudoaneurysm, and three patients had injury of a common linguo-facial trunk. Eight patients were treated by endovascular embolization using NBCA glue, and two patients had to be embolized using microcoils. All patients were successfully embolized with no clinical complications. One patient suffered from bleeding during the interventional procedure that was controlled by NBCA which infiltrated normal branches with no clinical sequelae. Conclusion NBCA glue can be used as an effective appropriate embolizing material in endovascular embolization of post-tonsillectomy pseudoaneurysm. However, certain precautions are mandatory to avoid distal infiltration of normal arteries or proximal reflux that may endanger the internal carotid artery. Level of Evidence Level 4, case series.