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Case report
Republished: Treatment of hemorrhagic head and neck lesions by direct puncture and n-BCA embolization
  1. Gerard Deib1,
  2. Amgad El Mekabaty2,
  3. Philippe Gailloud1,
  4. Monica Smith Pearl2,3
  1. 1 Division of Interventional Neuroradiology, Johns Hopkins Hospital and Health System, Baltimore, Maryland, USA
  2. 2 Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
  3. 3 Department of Radiology, Children’s National Medical Center, District of Columbia, USA
  1. Correspondence to Dr Monica Smith Pearl, Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA; msmit135{at}


Life-threatening bleeding in the head and neck region requires urgent management. These hemorrhagic lesions, for example, a ruptured pseudoaneurysm, are often treated by transarterial embolization (TAE), but prior intervention or surgery, inflammation, anatomic variants, and vessel tortuosity may render an endovascular approach challenging, time-consuming, and sometimes impossible. We report two cases of severe head and neck hemorrhages successfully embolized with n-butyl cyanoacrylate via direct puncture, and propose this approach as a fast, safe, and effective alternative to TAE.

  • intervention
  • liquid embolic material
  • neck
  • technique

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  • Republished with permission from BMJ Case Reports Published 24 October 2017; doi: 10.1136/bcr-2017-013335

  • Contributors All authors have fulfilled criteria for authorship.

  • Competing interests None declared.

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