Endovascular management of carotid blowout.

Publication/Presentation Date

7-1-2012

Abstract

OBJECTIVE: To highlight pertinent aspects of emergent endovascular management of carotid rupture, or carotid blowout syndrome (CBS), an emergent, life-threatening complication of head and neck cancer and its treatments.

METHODS: A retrospective chart review was conducted of all patients with carotid blowouts at the authors' institution from 2008-2010. A systematic literature review was also performed.

RESULTS: Eight patients (three women and five men) with an average age of 61 years (range 47-78 years) were reviewed. Seven patients had a positive history for squamous cell carcinoma of the neck, and five patients had active malignant disease. Carotid arterial deconstruction using liquid embolic material, coil embolization, or both achieved immediate hemostasis in every case (100%). No patients died as a result of their initial hemorrhage, but one patient had lethal hemorrhage at 1 day postoperatively. Two patients experienced nonlethal postoperative complications. At an average follow-up of 3 months (range< 1-8 months), three patients were alive, three had died as a result of their underlying disease, and two had died of other causes.

CONCLUSIONS: The treatment of patients with terminal malignant disease and CBS should provide maximum relief and minimize the risks of repeat surgery, morbidity, and mortality. Endovascular management of CBS with deconstructive techniques achieves immediate hemostasis and definitive treatment. The risks of intraoperative mortality and recurrent hemorrhage are low.

Volume

78

Issue

1-2

First Page

109

Last Page

114

ISSN

1878-8769

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

22120297

Department(s)

Administration and Leadership

Document Type

Article

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