Hemorrhage management

1. Patient was transferred in the radiology department. The procedure was performed through a fluoroscopy system (Multidiagnost Eleva, Philips Medical System, Best, The Netherlands).
2. Radiologist identified the left external carotid artery through right groin site puncture.
3. The culprit left superior thyroid artery was cannulated with a 0.018-inch microcatheter (Maestro 2.4 French; Merit Medical, South Jordan, UT). Angiogram demonstrated an irregular vessel.
4. The vessel was occluded with a pushable coil MicroNester® 0.2x3cm (Cook Medical, Bloomington, Indiana, USA) (Figure 2 c, d).
5. The bleeding subsequently resolved. There was no recurrence of the hemorrhage but the patient died 5 days later (d14) due to multivisceral organ failure and septic collapse.