Hemorrhage management
- Patient was transferred in the radiology department. The procedure was
performed through a fluoroscopy system (Multidiagnost Eleva, Philips
Medical System, Best, The Netherlands).
- Radiologist identified the left external carotid artery through right
groin site puncture.
- The culprit left superior thyroid artery was cannulated with a
0.018-inch microcatheter (Maestro 2.4 French; Merit Medical, South
Jordan, UT). Angiogram demonstrated an irregular vessel.
- The vessel was occluded with a pushable coil MicroNester® 0.2x3cm
(Cook Medical, Bloomington, Indiana, USA) (Figure 2 c, d).
- The bleeding subsequently resolved. There was no recurrence of the
hemorrhage but the patient died 5 days later (d14) due to
multivisceral organ failure and septic collapse.