Interventional Embolization: A Reliable Approach For Severe Maxillofacial Hemorrhage

Life-threatening hemorrhage associated with maxillofacial trauma and jaw fractures is rare, occurring in approximately 1.2%–4.5% of cases. The most commonly involved vessels are the maxillary artery and its branches or the external carotid artery. Conventional hemostatic measures are often ineffective in such situations, and emergency interventions such as surgical exploration or external carotid artery ligation may be attempted. However, these methods are associated with prolonged procedural time, uncertain efficacy, inadvertent ligation, and ischemic complications, particularly in patients with bilateral vascular injuries. Interventional embolization is a minimally invasive technique that delivers embolic agents via catheter to occlude bleeding vessels, achieving rapid and precise hemostasis. It offers advantages including speed, accuracy, minimal trauma, broad applicability, high safety, and low complication rates. We present a case of severe active hemorrhage due to maxillofacial trauma. Upon admission, the patient was in shock and required emergency blood transfusion and diagnostic imaging. Spiral CT revealed bilateral LeFort I fractures of the maxilla and mandibular fractures, with suspected bilateral maxillary artery rupture. Immediate bilateral interventional embolization successfully controlled the bleeding and saved the patient’s life. Should Interventional Embolization be the First-Line Treatment for Severe Maxillofacial Hemorrhage? This report highlights the efficacy and safety of interventional embolization in managing severe maxillofacial hemorrhage, suggesting it should be prioritized in such critical scenarios.