Migrating coils after bilateral embolization of external carotid artery: a case report

Introduction:

We report the case of a patient with a coil migrating into the larynx 25 months after undergoing bilateral embolization of the external carotid artery.

Methods:

In a 50-year-old male patient diagnosed with transglottic squamous cell larynx carcinoma, we performed a partial laryngectomy with laser via transoral approach and a selective neck dissection followed by adjuvant radiotherapy (pT2pN1M0R0.

5 months later the patient we performed surgical tracheostomy due to dyspnea and several specimens from the larynx were taken. In the course of hospitalization multiple hemorrhagings failed to be managed with transoral surgical hemostasis. Consequently endovascular bilateral embolization of the external carotid artery with coils was used to stop the bleeding. During a 25 months follow-up period no relapse was detected and we subsequently scheduled the patient for surgical closure of the tracheostoma. During hospital admission a thin wire was found in the subglottic larynx which we surgically recovered. The patient reported more such wires which he had himself removed in the last months. In a 6 months follow-up period s/p surgical closure of the tracheostoma, no relapse was detected and no events of migrated coils were reported.

Results:

Cases of migrated coils after embolization have so far only been reported in the kidney, the urinary as well as in the gastrointestinal tract.

In a pubmed based research no such case could be found for the head and neck region. Coils migrating into the aerodigestive tract are a dangerous complication.

Conclusions:

This is the first report of migrating coils into the aerodigestive tract. However, the risk of migrating coils should be considered, when weighing the odds of an endovascular embolization versus a surgical ligation.

Publication History

Publication Date:
18 April 2018 (online)