RT Journal Article SR Electronic T1 Republished: Delayed extrusion of embolic coils into the airway after embolization of an external carotid artery pseudoaneurysm JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP e18 OP e18 DO 10.1136/neurintsurg-2017-013178.rep VO 10 IS 7 A1 Zachary Wilseck A1 Luis Savastano A1 Neeraj Chaudhary A1 Aditya S Pandey A1 Julius Griauzde A1 Sumanna Sankaran A1 David Wilkinson A1 Joseph J Gemmete YR 2018 UL http://jnis.bmj.com/content/10/7/e18.abstract AB Carotid blowout syndrome (CBS) is a known devastating complication of head and neck surgery. The risk of developing CBS increases in the setting of radiation therapy, wound breakdown, or tumor recurrence. Traditionally, the treatment of choice for CBS is surgical ligation of the bleeding artery; however, recently, endovascular occlusion has become a more common option. If a pseudoaneurysm is present, treatment consists of trapping with endovascular coils or occlusion with a liquid embolic agent. Delayed migration of embolization coils into the airway causing acute respiratory distress is a rare occurrence. This report presents a case of a 57-year-old woman who presented to her otolaryngologist after experiencing an episode of acute respiratory distress which resolved when she expectorated embolization coil material from her tracheostomy tube. Three months prior to the episode she underwent coil embolization of an external carotid artery pseudoaneurysm for life-threatening hemorrhage.