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Maxillary Artery Pseudoaneurysm After Le Fort I Osteotomy: Treatment Using Transcatheter Arterial Embolization

Life-threatening hemorrhage is a rare complication after Le Fort I osteotomy. However, owing to the gravity of this complication, all surgeons who perform Le Fort I osteotomy should be aware of the potential for this complication and options for its resolution. The following case report describes an episode of subacute, life-threatening bleeding, after a Le Fort I osteotomy for the treatment of midface hypoplasia. Emergent angiographic evaluation demonstrated an internal maxillary artery pseudoaneurysm with fistulous drainage via the cavernous sinus. This was treated by arterial embolization in which the pseudoaneurysm was packed with microcoils. This report reaffirms the importance of maintaining a high clinical suspicion for pseudoaneurysm as a possible etiology of delayed postoperative bleeding in patients after craniomaxillofacial surgery.