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Endovascular Treatment to Stop Life-threatening Bleeding from Branches of the External Carotid Artery in Patients with Traumatic Maxillofacial Fracture
Journal of Cerebrovascular and Endovascular Neurosurgery ; : 83-89, 2016.
Article in English | WPRIM | ID: wpr-144503
ABSTRACT

OBJECTIVE:

The purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures. MATERIALS AND

METHODS:

A total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding. Various clinical factors were recorded for each patient and the correlations between those factors and clinical outcome (Glasgow Outcome Scale, GOS) were evaluated.

RESULTS:

Four patients were injured in traffic accidents, five in falls, and three by assaults. Mean initial Glasgow Coma Scale (GCS) was 6.9 ± 2.1 and the lowest hemoglobin measured was mean 6.3 ± 0.9 g/dL. GOS at discharge was 4 in five patients, 3 in three patients, and 1 (death) in four patients. GOS on follow-up (mean 13.7 months) was 5 in two patients, 4 in three patients, and 3 in three patients. Initial GCS (p = 0.016), lowest systolic blood pressure (p = 0.011), and lowest body temperature (p = 0.012) showed a significant positive correlation with good clinical outcomes. The number of units of red blood cells transfused (p = 0.030), the number of units of fresh frozen plasma transfused (p = 0.013), and the time from arrival to groin puncture (p < 0.001) showed significant negative correlation with good clinical outcomes.

CONCLUSION:

It might be suggested that rapid transition to EVT could be preferable to struggling with other rescue strategies to stop life-threatening bleeding from branches of the ECA in patients with traumatic maxillofacial fractures.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Plasma / Blood Pressure / Body Temperature / Accidental Falls / Carotid Artery, External / Accidents, Traffic / Punctures / Glasgow Coma Scale / Follow-Up Studies / Erythrocytes Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Journal of Cerebrovascular and Endovascular Neurosurgery Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Plasma / Blood Pressure / Body Temperature / Accidental Falls / Carotid Artery, External / Accidents, Traffic / Punctures / Glasgow Coma Scale / Follow-Up Studies / Erythrocytes Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Journal of Cerebrovascular and Endovascular Neurosurgery Year: 2016 Type: Article