Embolisation of Vertebral Artery Damaged Following Cervical Disc Removal

Borkert, Johannes and Hirte, Annika and Reimers, Jacobus and Jochmann, Nicoline and Nikol, Sigrid (2015) Embolisation of Vertebral Artery Damaged Following Cervical Disc Removal. European Journal of Case Reports in Internal Medicine, 2 (6). pp. 1-3. ISSN 2284-2594

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Introduction: The incidence of vertebral artery (VA) injury during cervical spine surgery is rare. Even though tamponade is effective in many cases, early consultation of an endovascular team is recommended if bleeding cannot be controlled. We report a case of emergent endovascular embolisation of left VA due to iatrogenic injury during anterior cervical disc removal and fusion. Case: A 47-year-old woman was admitted to our emergency department with serious arterial bleeding from the neck only hours after undergoing anterior cervical disc removal and fusion surgery. She was intubated and mechanically ventilated, however hemorrhage could not be successfully controlled by packing with surgical hemostatic agents. Cranial computed tomography, computed tomography of the cervical spine and CT angiography confirmed the suspected diagnosis of injury to the VA. Emergent endovascular embolisation successfully stopped the bleeding. Occlusion of the vessel was achieved by vascular plugging. The patient was discharged from our hospital 14 days after the intervention, receiving a revision surgery of the cervical spine on the day of embolisation. At the date of discharge she presented without any focal neurological deficit. Conclusion: Pre-operative radiographic imaging of the cervical spine should be used routinely to identify anatomic abnormalities of the vertebral arteries. Endovascular embolisation appears to be effective in treating acute iatrogenic dissection of the vertebral arteries.

Item Type: Article
Uncontrolled Keywords: Vertebral artery injury; embolisation
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.8 Malattie del sistema nervoso e disturbi mentali (Classificare qui la Neuropsichiatria, la Neurologia) > 616.83 Altre malattie organiche del sistema nervoso centrale (Include la corea ed i disturbi coreici ad eccezione della malattia di Huntington (in 616.851) (Classificare qui, in 616.83, le malattie dei gangli vasali, del midollo spinale)
Depositing User: Chiara D'Arpa
Date Deposited: 14 Sep 2016 14:56
Last Modified: 14 Sep 2016 14:56
URI: http://eprints.bice.rm.cnr.it/id/eprint/15069

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