Introduction: An intrathoracic bleeding from the thyrocervical branch is not common in blunt trauma, but an interventional radiologist should be aware of the risks in order to prevent complications. Case presentation: A 30-year-old male presented with a right pneumo-haemothorax due to active bleeding revealed at contrast-enhanced CT, as a consequence of a fall occurred in the previous week. The patient was treated with endovascular embolisation in an angiographic room with coils placement, since the right thyrocervical artery was found to be supplying the pneumo-haemothorax. A radiculo-medullary branch rose from the thyrocervical trunk, impeding the proximal embolization with microparticles and needing selective isolation of the bleeding artery with the catheter to avoid spinal cord injuries. The treatment had a successful result and the following CT control showed signs of recovering, without any complication. Conclusion: Our paper presents a rare contingency, warning the operator to bear in mind the presence of arteries feeding the spinal cord. This crucial detail precludes the use of microparticles embolisation to prevent neurologic sequelae, whereas the use of endovascular coils for embolization should be mandatory. Moreover, this case reminds that the post-traumatic bleeding deriving from a cervical trauma may also occur later.

Pitfalls in the embolisation of a thyrocervical trunk bleeding: A case report

Perrucci L.
Primo
;
Graziano M.
Secondo
;
Ferrante Z.;Salviato E.;Carnevale A.
Penultimo
;
Galeotti R.
Ultimo
2020

Abstract

Introduction: An intrathoracic bleeding from the thyrocervical branch is not common in blunt trauma, but an interventional radiologist should be aware of the risks in order to prevent complications. Case presentation: A 30-year-old male presented with a right pneumo-haemothorax due to active bleeding revealed at contrast-enhanced CT, as a consequence of a fall occurred in the previous week. The patient was treated with endovascular embolisation in an angiographic room with coils placement, since the right thyrocervical artery was found to be supplying the pneumo-haemothorax. A radiculo-medullary branch rose from the thyrocervical trunk, impeding the proximal embolization with microparticles and needing selective isolation of the bleeding artery with the catheter to avoid spinal cord injuries. The treatment had a successful result and the following CT control showed signs of recovering, without any complication. Conclusion: Our paper presents a rare contingency, warning the operator to bear in mind the presence of arteries feeding the spinal cord. This crucial detail precludes the use of microparticles embolisation to prevent neurologic sequelae, whereas the use of endovascular coils for embolization should be mandatory. Moreover, this case reminds that the post-traumatic bleeding deriving from a cervical trauma may also occur later.
2020
Perrucci, L.; Graziano, M.; Ferrante, Z.; Salviato, E.; Carnevale, A.; Galeotti, R.
File in questo prodotto:
File Dimensione Formato  
s13037-020-00244-8.pdf

accesso aperto

Tipologia: Full text (versione editoriale)
Licenza: Creative commons
Dimensione 1.71 MB
Formato Adobe PDF
1.71 MB Adobe PDF Visualizza/Apri

I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2420921
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 1
social impact