Role of CT angiography and embolisation in the management of life-threatening haemorrhage following microvascular head and neck reconstruction

Summary 

Post-operative haemorrhage in the head and neck cancer patient can have a catastrophic outcome either for the patient or the free flap if microvascular reconstruction has been performed. The life of the patient always takes priority over the flap; however the pedicle can be at risk when the patient is returned to theatre for arrest of the haemorrhage. CT angiography is a good non-invasive method of determining the source of bleeding and facilitating superselective embolisation, minimizing risk to the flap pedicle. We present a case which this treatment was successfully used with a good result and would recommend its use when similar situations occur.

Keywords: pseudoaneurysm, haemorrhage, maxillary artery, embolisation, microvascular reconstruction