Successful Endovascular Therapy of a Penetrating Zone III Jugular Bulb Injury

Abstract

<jats:p> Penetrating venous injuries via Zone III of the neck extended over jugular bulb are rare. The optimal strategies for these venous injuries are currently unknown because many of the vital structures in this region are poorly accessible to the surgeon and therefore it is difficult to control bleeding. A 76-year-old man got drunk and fell down onto a paper door. The wooden framework of the paper door was broken and got stuck deep in the right side of his neck. Enhanced computed tomography showed the wood stick had penetrated through the right jugular foramen and injured the jugular bulb. We successfully performed right sigmoid and jugular vein occlusion via an endovascular approach using Guglielmi detachable coils at first and then to draw out the wood stick in order to avoid venous bleeding. To our best knowledge, these venous injuries have reported in only four cases. Only one case was performed by endovascular approach using n-butyl cyanoacrylate (NBCA). Coil embolization is much better than NBCA in the light of reducing complications due to adhesion to the inserted wood stick and embolization of unintended vessels. Venous occlusion using coil embolization is the best way to treat a penetrating jugular bulb injury via zone III because of reducing the hemorrhage and air embolism. </jats:p>

Endovascular Treatment for Head and Neck Trauma

“…관통상에 속발한 경부 혈관 손상에 대해서는 보존적 치료 상황이 아니라면 수술적 치료에 보완적으로 혈관내 인터벤션의 경우에도 증례 보고 등의 후향적 연구 결과에서 효과적인 치료가 가능했다는 점은 증명되어 있다( 44 45 46 47 ). 경우에 따라서는 혈관내 인터벤션 단독으로도 좋은 결과를 얻을 수도 있겠다( Fig.…”