Abstract
Objective: We describe transarterial embolization with n-butyl 2-cyanoacrylate (NBCA) to treat maxillofacial injury caused by impalement.
Case presentation: A pipe fell onto the face of a 39-year-old male construction worker through the medial border of the left eye and became embedded under the skin of the left posterior auricular area via the left maxillary air sinus. Angiography revealed damage to the left internal maxillary artery and hemostasis caused by the pipe. Massive bleeding occurred while the pipe was being surgically extracted and replaced with a balloon, which is usually used for hemostasis of an esophageal varix. Coil embolization under balloon inflation failed to stop bleeding from the wound because coils migrated from the torn ends of vessels. NBCA injection through a microcatheter resulted in complete hemostasis. The patient recovered well with mild diplopia and facial palsy after subsequent treatments.
Conclusion: Transarterial embolization with NBCA is a highly effective treatment for severe traumatic vessel injuries of maxillofacial lesions with emergent hemostasis.
