Extraction of a headscarf pin from the vertebral artery without embolization

Authors

  • Ophir Ilan MD, PhD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
    • Department of Otolaryngology–Head and Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
    Search for more papers by this author
  • Jeffrey M. Weinberger MD, FRCS(C),

    1. Department of Otolaryngology–Head and Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
    Search for more papers by this author
  • J. Moshe Gomori MD,

    1. Department of Radiology, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
    Search for more papers by this author
  • Menachem Gross MD

    1. Department of Otolaryngology–Head and Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
    Search for more papers by this author

Abstract

Background

Foreign bodies traversing the aerodigestive tract lining into the surrounding soft tissues is a well-known entity. A 14-year-old girl was referred to our hospital after swallowing a pin that was not visualized by laryngoscopy, despite a neck film that localized it to the level of the larynx.

Methods

A CT scan demonstrated a bent pin piercing the left vertebral artery “through and through,” and this was confirmed by angiography. The pin was extracted via an external approach to the neck without preoperative intravascular manipulation.

Results

Angiography immediately after the surgery demonstrated a stable thrombotic sleeve in the vertebral artery without further clot propagation or bleeding from the vessel wall. This is the first report of a “through and through” thrombotic sleeve in an artery.

Conclusions

Simple surgical removal of a sharp foreign body from the vertebral artery without intravascular management may be a reasonable option. © 2010 Wiley Periodicals, Inc. Head Neck, 2012

Ancillary