Use of transcatheter arterial embolization to treat a case of massive arterial bleeding caused by a traumatic aneurysm developing after tooth extraction

Abstract

Transcatheter arterial embolization (TAE) is an effective and minimally invasive treatment against uncontrolled arterial bleeding. We report a traumatic aneurysm that occurred after tooth extraction and was treated by TAE. A 48-year-old woman was referred to our hospital because of uncontrolled intraoral arterial bleeding 4 days after third molar extraction. In her medical history, she had been treated for liver cirrhosis and hepatocellular carcinoma. A pseudoaneurysm of the inferior alveolar artery was found on selective carotid angiography. Massive arterial bleeding from the aneurysm was successfully treated by TAE. TAE and selective carotid angiography were useful for the management of hemorrhage probably caused by a traumatic aneurysm after tooth extraction.

An Unusual Presentation of a Neck Mass – Traumatic Pseudoaneurysm Following Third Molar Surgery: A Case Report

“…13 TPA related to dental extractions have been reported to occur at the lingual artery, internal maxillary artery, facial artery, and inferior alveolar artery. 3,[6][7][8][9][10]14,15 When there is clinical concern for the occurrence of a TPA, a CTA remains the preferred diagnostic modality for initial evaluation. 11 However, when a CTA cannot be obtained, the utilization of ultrasonography and color Doppler can also verify a pseudoaneurysm with the visualization of bidirectional blood flow as shown in this case.…”

“…Traumatic pseudoaneurysm (TPA) formation is an extremely rare complication which has been reported in the literature as a potential sequela following tooth extraction. [3][4][5][6][7][8][9][10][11] In the maxillofacial region, TPA is most often associated with penetrating trauma, condylar fractures, and orthognathic surgery and involves the branches of the internal maxillary artery. 3,4 TPA occurs when there is disruption in the vascular endothelium followed by blood extravasation into the adventitia or adjacent soft tissue.…”