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KMID : 1148420230060010035
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Journal of Neurointensive Care
2023 Volume.6 No. 1 p.35 ~ p.41
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The Role of Angiographic Interventions in Life-Threatening Traumatic Maxillofacial Bleeding
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Yu Jae-Min
Choi Jong-Wook
Whang Kum
Oh Ji-Woong
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Abstract
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Background : Intravascular embolization is an effective treatment option for cases of trauma induced massive maxillofacial bleeding (MFB). Yet, a viable guideline for endovascular treatment of MFB has not been established. This article investigates on parameters to distinguish suitable candidates of endovascular embolization among trauma victims with MFB, and discusses factors related to clinical outcomes.
Methods : From January 2015 to December 2018, 24 massive MFB patients underwent tranas-femoral angiography, and 16 of them proceeded with endovascular embolization (embolization group) while the other 8 patients only received angiography as no extravasation was observed (non-embolization group). We compared laboratory values and clinical factors related to the massive blood loss between the embolization group and the non-embolization group.
Results : Compared with the non-embolization group, the patients of the embolization group had a trend of lower values in hemoglobin (7.9 ± 3.6 g/dL vs 11.6 ± 2.3 g/dL, p = 0.047), base excess (-14.73 vs -6.9, p = 0.002), and systolic & diastolic blood pressure (100.5mmHg vs 59.9mmHg, 66.0 mmHg vs 30.9mmHg, respectively, p < 0.05). The overall mortality rate was 66.7% (87.5% in the embolization group, 25% in the non-embolization group). In the embolization group, there was no significant difference in all clinical and laboratory values between survivors and non-survivors.
Conclusion : This study suggests initial hemoglobin, base-excess and low blood pressure as possible indicators to distinguish potential beneficiaries of facial embolization among MFB victims. However, it failed to find the viable prognosis factors to predict the clinical outcome of the embolization.
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KEYWORD
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Maxillofacial injury, Therapeutic embolization, Traumatic brain injury
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