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Head and Neck
Case series
Embolization through the thyrocervical trunk: vascular anatomy, variants, and a case series
  1. Carlos Pérez-García1,
  2. Carlos Malfaz2,
  3. Mariano del Valle Diéguez1,
  4. Fernando Fortea Gil1,
  5. Javier Saura Lorente1,
  6. Miguel Echenagusia Boyra3,
  7. Manuel González Leyte3,
  8. Antonio Pérez-Higueras4,
  9. Enrique Castro-Reyes1
  1. 1 Department of Interventional Neuroradiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  2. 2 Department of Neuroradiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  3. 3 Department of Vascular Interventional Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  4. 4 Department of Interventional Neuroradiology, Hospital Ruber Internacional, Madrid, Spain
  1. Correspondence to Dr Carlos Pérez-García, Department of Interventional Neuroradiology, HospitalGeneral Universitario Gregorio Marañón, Madrid 28007, Spain; cperezgarcia.med{at}gmail.com

Abstract

Background and purpose The thyrocervical trunk (TCT) is the second ascending branch of the subclavian artery. It is considered a ‘border territory’ between interventional vascular radiology and interventional neuroradiology because it gives rise to branches both cervical and to the upper limbs. We describe the TCT branches anatomy, the most frequent variants, and expose eight endovascular procedures performed through the thyrocervical trunk.

Methods A retrospective review of all the interventional radiology procedures carried out through the TCT in our tertiary care center from August 2014 to January 2017 is presented.

Results A total of eight endovascular procedures through the TCT including six preoperative embolizations: three paragangliomas, a cervical vertebral metastasis, a cervical vertebral aneurysmal bone cyst, and a very rare case of nerve root extradural cervical hemangioblastoma, as well as two emergency embolizations: a patient with a cervical traumatic active bleeding hematoma and a recurrent hemoptysis in a single ventricle patient.

Conclusions A correct knowledge of the vascular anatomy, anatomical variants, and anastomosis (especially with the anterior spinal artery) of the TCT is essential for a safe embolization, both preoperatively and on an emergency basis. In cases of recurrent hemoptysis and severe lower-neck injuries, the TCT should always be reviewed.

  • cervical
  • intervention
  • neoplasm
  • spinal cord
  • hemorrhage

https://doi.org/10.1136/neurintsurg-2018-013808

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    Footnotes

    • Contributors Protocol/project development: EC-R, CP-G, CM. Interventional procedures performance: EC-R, MdVD, FFG, JSL, MJEB, MGL, AP-H. Data collection and management: CP-G, CM, EC-R, MdVD, FFG, JSL, MJEB, MGL, AP-H. Manuscript writing/editing: CP-G, EC-R, CM. Revising the work critically for important intellectual content: CP-G, CM, EC-R, MdVD, FFG, JSL, MJEB, MGL, AP-H. Manuscript final approval: CP-G, CM, EC-R, MdVD, FFG, JSL, MJEB, MGL, AP-H. Agreement to be accountable for all aspects of the work: CP-G, CM, EC-R, MdVD, FFG, JSL, MJEB, MGL, AP-H.

    • Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Provenance and peer review Not commissioned; externally peer reviewed.