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  • Title: Transarterial embolization of acute external carotid blowout syndrome with profuse oronasal bleeding by N-butyl-cyanoacrylate.
    Author: Luo CB, Teng MM, Chang FC, Chang CY.
    Journal: Am J Emerg Med; 2006 Oct; 24(6):702-8. PubMed ID: 16984839.
    Abstract:
    OBJECTIVES: Assess duration, efficacy, and safety of emergent transarterial embolization of acute external carotid blowout syndrome (ECBS) with N-butyl-cyanoacrylate. METHODS: Medical records were reviewed for 16 patients (15 men, 1 woman; age range, 28-85 years) who had 17 acute ECBS events that presented with profuse transoronasal bleeding. Predisposing factors were carcinoma associated with surgery and/or radiotherapy (n = 14) or trauma (n = 3). Affected arteries were the internal maxillary artery (n = 5), superior thyroid artery (n = 4), lingual artery (n = 4), facial artery (n = 2), or ascending pharyngeal artery (n = 2). RESULTS: Endovascular treatment successfully obliterated all acute ECBSs with cessation of profuse hemorrhage. Mean duration of procedure was 54 minutes. Three patients had recurrent carotid blowout syndrome events, with 1 resulting death. Clinical follow-up range was 2 to 23 months. CONCLUSIONS: Transarterial N-butyl-cyanoacrylate embolization can successfully manage acute ECBS with profuse hemorrhage. The technique is both efficient and safe, and the procedure can be rapidly completed.
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