Đánh giá hiệu quả nút mạch điều trị chảy máu hàm mặt do chấn thương

Evaluation the effectiveness of arterial embolization in the treatment of maxillofacial trauma

SUMMARY

Purpose: This study was designed to characterize image of vascular lesions on DSA and evaluate the effectiveness of arterial embolization in the treatment of maxillofacial trauma.

Materials and Methods: 44 patients with bleeding after jaw injury, did not meet with the local hemostatic measures who were taken to the angiography for embolization from April 2011 to September 2015.

Results: 13.6% of the internal carotid artery injury with 4.5% of dissection and 9.1% of carotid-cavernous sinus fistula. 90,1% of the external carotid artery injury, the (internal) maxillary artery is the most vulnerable (in 88.6%) that the maxillary artery injury merely in 56.8% or combination in 31.8%. The external carotid artery injury of a side in 59.1%, 40.9% of two side. Active bleeding is the most common of injury morphology (88,6,6%), with 63.6% merely, and associated with other forms 25%, (pseudoaneurysms, arteriovenous malformation, the internal carotid artery injury), pseudoaneurysm merely is a rare lesions in 2.3%. Hystoacryl is the most common embolization material (86.3%), 59.1% of Hystoacryl merely and coordinate 13.6%. PVA embolization merely in 13.6%; Spongel in 13.6%; no circumstances used to try Coil. Technical success was 95.4%, 4.6% failed. Successful hemostasis was achieved in 95.4% after the first intervention and 100% after 2nd intervention. Clinical success was achieved in 79.6%. Clinical non-success included 7 patients died of severe traumatic brain injury (15.9%) and 2 patients (4.5%) had complications, including 1 patient with face necrosis and 1 patient with tongue necrosis.

Conclusion: Arterial Embolization in the Treatment of Maxillofacial Trauma was effective and quick to control bleeding.

Keywords: bleeding, maxillofacial trauma, Embolization.