A case of vertebral artery embolization for a vertebral artery injury caused by glass fragments

Abstract

An 80-year-old woman was admitted to our emergency department with hemorrhagic shock caused by a neck-penetrating glass injury after falling. Her family had removed the glass following the injury. On admission, the patient had hemorrhagic instability with active bleeding from the left neck and continuous finger compression was effective for temporal hemostasis. The surgical approach to Zone III neck injury was challenging, thereafter we decide to perform cerebral angiography. Left vertebral artery (VA) angiography showed active bleeding from the left main trunk of the V3 segment of VA. After undergoing endovascular parent artery embolization, the patient's hemostasis was accomplished. The formation of the V3 segment of VA injury caused by stab wounds is a rare vascular anomaly. Endovascular treatment could be considered if there is difficulty in detecting the source of bleeding in the injured regions that are challenging to operatively access. We concluded that endovascular treatment should be considered first in cases of injury to the V2 or V3 segment of VA.