Treatment and experience of traumatic carotid artery injury with massive epistaxis

Abstract

A retrospective analysis was made on 5 cases who had the traumatic carotid artery injury with massive epistaxis (from September 2007 to June 2011). All of them were finally diagnosed by digital substraction angiography (DSA). Among them, 2 cases of traumatic pesudoaneurysm from internal maxillary artery were embolized with polyvinyl alcohol particles and gelatin sponge. One case was carotid-cavernous fistula (CCF) with traumatic pesudoaneurysm located in the sphenoid sinus. This patient's internal carotid artery (ICA) and fistula was blocked with balloon, and then ICA was clipped proximal to the posterior communicating artery. One case with injuried ICA was treated with blocking by balloon. The pesudoaneurysm located in ICA cavernous segment of one case was embolized with coil and liquid glue. No recurrence was found after successful surgeries. Patients with massive epistaxis or recurrent epistaxis after craniofacial trauma should undergo CT angiography (CTA) or DSA examination so as to get proper diagnosis and treatment as early as possible.