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Percutaneous puncture of the external carotid artery or its branches after surgical ligation
Y P Gobin1, A Pasco, J J Merland
1Service de Neuroradiologie, Hopital Lariboisière, Paris, France.
Insights
Percutaneous puncture distal to external carotid artery ligation enables successful embolization. This technique provides a viable option for treating vascular lesions after surgical ligation, with a high success rate and manageable complications.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Endovascular Therapy
Background:
- Surgical ligation of the external carotid artery (ECA) or its branches can complicate subsequent endovascular interventions.
- Accessing distal vessels after ECA ligation presents a technical challenge.
Purpose of the Study:
- To detail the methodology and outcomes of percutaneous arterial puncture performed distal to a prior surgical ligation of the ECA or its branches.
- To evaluate the feasibility and safety of this approach for endovascular treatment.
Main Methods:
- A retrospective analysis of 64 embolization attempts in 43 patients who underwent percutaneous puncture distal to ECA ligation.
- Punctured arteries included the ECA trunk, internal maxillary, facial, lingual, occipital, and superficial temporal arteries.
Main Results:
- A high technical success rate was achieved, with 57 of 64 attempts successful in a single session.
- Six attempts required two sessions for success, and one attempt failed.
- Puncture-related complications included eight self-resolving hematomas and six asymptomatic internal carotid artery punctures.
Conclusions:
- Percutaneous arterial puncture distal to surgical ECA ligation is an effective technique.
- This approach facilitates selective catheterization and endovascular occlusion of vascular lesions in previously ligated territories.
Purpose:
To describe the technique and results of percutaneous puncture of the external carotid artery or one of its branches distal to a surgical arterial ligation.
Methods:
Forty-three patients underwent 64 embolization attempts by percutaneous arterial puncture distal to an external carotid artery ligation. The punctured arteries were the trunk of the external carotid artery in 31 patients, the internal maxillary artery in nine, the facial artery in nine, the lingual artery in eight, the occipital artery in four, and the superficial temporal artery in three.
Results:
In 64 attempts 57 were successful in one session, six were successful in two sessions, and one failed. Puncture-related complications were eight spontaneously resolving hematomas and six asymptomatic punctures of the internal carotid artery.
Conclusion:
After surgical ligation of the external carotid artery or its branches, arterial puncture above the ligation allowed selective catheterization and endovascular occlusion of vascular lesions.