Extraction of a headscarf pin from the vertebral artery without embolization

Background Foreign bodies traversing the aerodigestive tract lining into the surrounding soft tissues is a well-known entity. A 14-year-old girl was referred to our hospital after swallowing a pin that was not visualized by laryngoscopy, despite a neck film that localized it to the level of the larynx. Methods A CT scan demonstrated a bent pin piercing the left vertebral artery “through and through,” and this was confirmed by angiography. The pin was extracted via an external approach to the neck without preoperative intravascular manipulation. Results Angiography immediately after the surgery demonstrated a stable thrombotic sleeve in the vertebral artery without further clot propagation or bleeding from the vessel wall. This is the first report of a “through and through” thrombotic sleeve in an artery. Conclusions Simple surgical removal of a sharp foreign body from the vertebral artery without intravascular management may be a reasonable option. © 2010 Wiley Periodicals, Inc. Head Neck, 2012