Arteriovenous Fistula of the Thyroid Gland Associated With Spontaneous Bleeding From a Flow-Induced Aneurysm of the Inferior Thyroid Artery Paul J. Klingler,

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Arteriovenous Fistula of the Thyroid Gland Associated With Spontaneous Bleeding From a Flow-Induced Aneurysm of the Inferior Thyroid Artery Paul J. Klingler, M.D., Martin C. Freund, M.D., Matthias H. Seelig, M.D., John M. Knudsen, M.D., J. Kirk Martin, M.D. Mayo Clinic Proceedings Volume 74, Issue 5, Pages 485-488 (May 1999) DOI: 10.4065/74.5.485 Copyright © 1999 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Contrast-enhanced computed tomogram at level of inferior pole of thyroid gland, showing large left-sided cervical hematoma displacing thyroid cartilage from left to right, which compresses and lateralizes common carotid artery, and internal jugular vein. Two large draining veins (arrow) originating from left thyroid lobe floated into dilated internal jugular vein. This is an indirect sign of increased flow caused by arteriovenous fistula. Mayo Clinic Proceedings 1999 74, 485-488DOI: (10.4065/74.5.485) Copyright © 1999 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Diagnostic angiogram with selective injection of left subclavian artery. Thyrocervical trunk with inferior thyroid artery (arrowhead) is shown in conjunction with arteriovenous fistula and flow-associated aneurysm (arrow). Mayo Clinic Proceedings 1999 74, 485-488DOI: (10.4065/74.5.485) Copyright © 1999 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 A, Digital subtraction angiogram during embolization of left inferior thyroid artery: stainless steel coils and gelfoam plug (Ethiblock) are ultraselectively placed through microcatheter (Tracker-18). B, Ultraselective angiogram of left inferior thyroid artery after embolization, demonstrating notable reduced flow through artery (arrow). Mayo Clinic Proceedings 1999 74, 485-488DOI: (10.4065/74.5.485) Copyright © 1999 Mayo Foundation for Medical Education and Research Terms and Conditions