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Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports

BACKGROUND: The ascending pharyngeal artery (APhA) comprises the pharyngeal trunk (PT) and neuromeningeal trunk. The PT feeds the nasopharynx and adjacent tissue, which potentially connects with the sphenopalatine artery (SPA), branched from the internal maxillary artery (IMA). Due to its location d...

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Autores principales: Yunaiyama, Daisuke, Takara, Yuki, Kobayashi, Takehiro, Muraki, Mika, Tanaka, Taro, Okubo, Mitsuru, Saguchi, Toru, Nakai, Motoki, Saito, Kazuhiro, Tsukahara, Kiyoaki, Ishii, Yuri, Homma, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669858/
https://www.ncbi.nlm.nih.gov/pubmed/36405265
http://dx.doi.org/10.12998/wjcc.v10.i32.12015
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author Yunaiyama, Daisuke
Takara, Yuki
Kobayashi, Takehiro
Muraki, Mika
Tanaka, Taro
Okubo, Mitsuru
Saguchi, Toru
Nakai, Motoki
Saito, Kazuhiro
Tsukahara, Kiyoaki
Ishii, Yuri
Homma, Hiroshi
author_facet Yunaiyama, Daisuke
Takara, Yuki
Kobayashi, Takehiro
Muraki, Mika
Tanaka, Taro
Okubo, Mitsuru
Saguchi, Toru
Nakai, Motoki
Saito, Kazuhiro
Tsukahara, Kiyoaki
Ishii, Yuri
Homma, Hiroshi
author_sort Yunaiyama, Daisuke
collection PubMed
description BACKGROUND: The ascending pharyngeal artery (APhA) comprises the pharyngeal trunk (PT) and neuromeningeal trunk. The PT feeds the nasopharynx and adjacent tissue, which potentially connects with the sphenopalatine artery (SPA), branched from the internal maxillary artery (IMA). Due to its location deep inside the body, the PT is rarely injured by trauma. Here, we present two cases that underwent transcatheter arterial embolization (TAE) of the PT of the APhA due to trauma and iatrogenic procedure. CASE SUMMARY: Case 1 is a 49-year-old Japanese woman who underwent transoral endoscopy under sedation for a medical check-up. The nasal airway was inserted as glossoptosis occurred during sedation. Bleeding from the nasopharynx was observed during the endoscopic procedure. As the bleeding continued, the patient was referred to our hospital for further treatment. Contrast-enhanced computed tomography (CT) demonstrated extravasation in the nasopharynx originating from the right Rosenmuller fossa. TAE was performed and the extravasation disappeared after embolization. Case 2 is a 28-year-old Japanese woman who fell from the sixth floor of a building and was transported to our hospital. Contrast-enhanced CT demonstrated a complex facial fracture accompanying extravasation in the left pterygopalatine fossa to the nasopharynx. Angiography demonstrated an irregular third portion of the IMA. As angiography after TAE of the IMA demonstrated extravasation from the PT of the APhA, additional TAE to the artery was performed. The bleeding stopped after the procedure. CONCLUSION: Radiologists should be aware that the PT of the APhA can be a bleeding source, which has a potential connection with the SPA.
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spelling pubmed-96698582022-11-18 Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports Yunaiyama, Daisuke Takara, Yuki Kobayashi, Takehiro Muraki, Mika Tanaka, Taro Okubo, Mitsuru Saguchi, Toru Nakai, Motoki Saito, Kazuhiro Tsukahara, Kiyoaki Ishii, Yuri Homma, Hiroshi World J Clin Cases Case Report BACKGROUND: The ascending pharyngeal artery (APhA) comprises the pharyngeal trunk (PT) and neuromeningeal trunk. The PT feeds the nasopharynx and adjacent tissue, which potentially connects with the sphenopalatine artery (SPA), branched from the internal maxillary artery (IMA). Due to its location deep inside the body, the PT is rarely injured by trauma. Here, we present two cases that underwent transcatheter arterial embolization (TAE) of the PT of the APhA due to trauma and iatrogenic procedure. CASE SUMMARY: Case 1 is a 49-year-old Japanese woman who underwent transoral endoscopy under sedation for a medical check-up. The nasal airway was inserted as glossoptosis occurred during sedation. Bleeding from the nasopharynx was observed during the endoscopic procedure. As the bleeding continued, the patient was referred to our hospital for further treatment. Contrast-enhanced computed tomography (CT) demonstrated extravasation in the nasopharynx originating from the right Rosenmuller fossa. TAE was performed and the extravasation disappeared after embolization. Case 2 is a 28-year-old Japanese woman who fell from the sixth floor of a building and was transported to our hospital. Contrast-enhanced CT demonstrated a complex facial fracture accompanying extravasation in the left pterygopalatine fossa to the nasopharynx. Angiography demonstrated an irregular third portion of the IMA. As angiography after TAE of the IMA demonstrated extravasation from the PT of the APhA, additional TAE to the artery was performed. The bleeding stopped after the procedure. CONCLUSION: Radiologists should be aware that the PT of the APhA can be a bleeding source, which has a potential connection with the SPA. Baishideng Publishing Group Inc 2022-11-16 2022-11-16 /pmc/articles/PMC9669858/ /pubmed/36405265 http://dx.doi.org/10.12998/wjcc.v10.i32.12015 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Yunaiyama, Daisuke
Takara, Yuki
Kobayashi, Takehiro
Muraki, Mika
Tanaka, Taro
Okubo, Mitsuru
Saguchi, Toru
Nakai, Motoki
Saito, Kazuhiro
Tsukahara, Kiyoaki
Ishii, Yuri
Homma, Hiroshi
Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports
title Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports
title_full Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports
title_fullStr Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports
title_full_unstemmed Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports
title_short Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports
title_sort transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: two case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669858/
https://www.ncbi.nlm.nih.gov/pubmed/36405265
http://dx.doi.org/10.12998/wjcc.v10.i32.12015
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