下顎水平埋伏智歯抜去時の下歯槽動脈分枝からの出血に対して経カテーテル的動脈塞栓術を施行した1例

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  • Transcatheter arterial embolization for bleeding from a branch of the inferior alveolar artery that started during removal of an impacted mandibular third molar
  • カガク スイヘイ マイフク チシ バツキョジ ノ シタ シソウ ドウミャク ブン シ カラ ノ シュッケツ ニ タイシテ ケイ カテーテルテキ ドウミャク ソクセンジュツ オ シコウ シタ 1レイ
  • — Report of a case —

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Transcatheter arterial embolization (TAE) has been used with increasing frequency in oral and maxillofacial surgery to achieve hemostasis in patients with various lesions such as aneurysms, arteriovenous malformations and hemangiomas. In this paper, we report the successful use of TAE to control arterial bleeding that started during removal of an impacted mandibular third molar. A 32-year-old male underwent elective removal of bilateral impacted mandibular third molars. During removal of alveolar bone around the left third molar, arterial bleeding suddenly occurred and could not be controlled using oxidized cellulose gauze and electrocoagulation. The bleeding was mild after 1 hour of digital pressure with gauze packing, but did not stop. The next day, TAE of the left inferior alveolar artery was performed using the Seldinger technique. During the procedure, leakage of radiopaque dye from a branch of the inferior alveolar artery was observed, indicating that the bleeding was caused by injury to this arterial branch. The inferior alveolar artery and the bleeding arterial branch were embolized with gelatin sponge and microcoils. Forty-two days after TAE, the left mandibular third molar was removed without any further complications.

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