Transcatheter arterial embolization in the treatment of facial injury

BACKGROUND: Maxillofacial injuries may be associated with a variety of problems including airway obstruction and hemorrhage. We studied retrospectively the patients who underwent transcatheter arterial embolization for facial hemorrhage. METHODS: We retrospectively evaluated medical charts of the 12 patients who underwent transcatheter arterial embolization for facial hemorrhage between January, 2000 and December, 2006. We decided clinical outcome using Glasgow Outcome Scale (GOS) and classified the patients into the favorable outcome group (GR: good recovery, MD: moderate disability), and poor outcome group (D: dead). We compared the two groups regarding blood pressure, pulse rate. Glasgow Coma Scale (GCS), Injury Severity Score (ISS), transufused volume, interval between injury and embolization. RESULTS: From 12 cases reviewed, nine were males and three were females. The mean age was 42 years (20-73 years). Three patients were GR, one patient was MD, and eight patients were D. In the poor outcome group, shock signs were more common, and GCS was lower. The ISS was correlated with the outcome. The mean interval between injury and embolization was 3.5 hours. CONCLUSION: Patients with maxillofacial injuries may be fatal. Airway and breathing maintenance are most important. When pressure and packing fail to control the hemorrhage, prompt transcatheter arterial embolization may be effective.