Emergent endovascular treatment of intractable head and neck hemorrhage

During the last 3 years, 11 patients with intractable head and neck hemorrhage (6 craniofacial injuries, 2 surgical complications, 2 nasopharyngeal carcinomas, and 1 mandibular arteriovenous malformation) were sent to our angiographic suite for emergency management. Arterial disruption with pseudoaneurysm formation was the most common angiographic finding. The arteries responsible for active bleeding included internal maxillary artery (most common), superficial temporal artery, facial artery, and lingual artery. Microcoils, particles, and liquid adhesives were used, separately or in combination, to achieve hemostasis successfully in 10 patients. No major complications related to the procedure occurred. Diagnostic angiography and therapeutic embolization can be performed promptly and effectively to treat patients with life-threatening hemorrhage in the head and neck region.