CT Angiography Findings in Carotid Blowout Syndrome and Its Role as a Predictor of 1-Year Survival

Lee, Chung-Wei; Yang, Chin‐Yi; Chen, Ya-Fang; Huang, Adam; Wang, Y. H.; Liu, Hon‐Man

doi:10.3174/ajnr.a3716

Cited by 37 publications

(32 citation statements)

References 20 publications

(26 reference statements)

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“…All our patients had at least one local soft tissue lesion or necrotic tumor as their peri-procedural clinical finding, which also implies their close relationship with the occurrence of PCBS ( Table 1 ) [ 6 , 7 ]. Soft tissue lesions are difficult to identify by angiogram [ 21 ]. Additionally, it is difficult to evaluate deeply located soft tissue lesions in HNC patients with trismus or previous surgical reconstruction by clinical examination.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Post-Irradiated Carotid Blowout Syndrome

et al. 2015

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PurposeTo retrospectively evaluate the clinical and technical factors related to the outcomes of endovascular management in patients with head-and-neck cancers associated with post-irradiated carotid blowout syndrome (PCBS).Materials and MethodsBetween 2000 and 2013, 96 patients with PCBS underwent endovascular management. The 40 patients with the pathological lesions located in the external carotid artery were classified as group 1 and were treated with embolization. The other 56 patients with the pathological lesions located in the trunk of the carotid artery were divided into 2 groups as follows: group 2A comprised the 38 patients treated with embolization, and group 2B comprised the 18 patients treated with stent-graft placement. Fisher’s exact test was used to examine endovascular methods, clinical severities, and postprocedural clinical diseases as predictors of outcomes.ResultsTechnical success and immediate hemostasis were achieved in all patients. The results according to endovascular methods (group 1 vs 2A vs 2B) were as follows: technical complication (1/40[2.5%] vs 9/38[23.7%] vs 9/18[50.0%], P = 0.0001); rebleeding (14/40[35.0%] vs 5/38[13.2%] vs 7/18[38.9%]), P = 0.0435). The results according to clinical severity (acute vs ongoing PCBS) were as follows: technical complication (15/47[31.9%] vs 4/49[8.2%], P = 0.0035); rebleeding (18/47[38.3%] vs 8/49[16.3%], P = 0.0155). The results according to post-procedural clinical disease (regressive vs progressive change) were as follows: alive (14/21[66.7%] vs 8/75[10.7%], P<0.0001); survival time (34.1±30.6[0.3–110] vs 3.6±4.0[0.07–22] months, P<0.0001).ConclusionThe outcomes of endovascular management of PCBS can be improved by taking embolization as a prior way of treatment, performing endovascular intervention in slight clinical severity and aggressive management of the post-procedural clinical disease.

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Section: Discussionmentioning

confidence: 99%

Endovascular Management of Post-Irradiated Carotid Blowout Syndrome

et al. 2015

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“…Endovascular management with occlusion of the CCA/ICA has substantially improved outcomes when it is correctly indicated. 7 , 57 , 82 However, this procedure can induce delayed cerebral ischemic complications resulting from an incomplete circle of Willis, thromboembolism arising from an acutely occluded carotid artery and/or delayed collateral failure. As an alternative, CBS can be managed by reconstructing the damaged artery with covered stents.…”

Section: Cbs After Reirradiation Of a Recurrent Tumormentioning

confidence: 99%

Carotid blowout syndrome: modern trends in management

Suárez¹,

Fernández-Álvarez²,

Hamoir³

et al. 2018

CMAR

106

136

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Carotid blowout syndrome (CBS) refers to rupture of the carotid artery and is an uncommon complication of head and neck cancer that can be rapidly fatal without prompt diagnosis and intervention. CBS develops when a damaged arterial wall cannot sustain its integrity against the patient’s blood pressure, mainly in patients who have undergone surgical procedures and radiotherapy due to cancer of the head and neck, or have been reirradiated for a recurrent or second primary tumor in the neck. Among patients irradiated prior to surgery, CBS is usually a result of wound breakdown, pharyngocutaneous fistula and infection. This complication has often been fatal in the past, but at the present time, early diagnosis and modern technology applied to its management have decreased morbidity and mortality rates. In addition to analysis of the causes and consequences of CBS, the purpose of this paper is to critically review methods for early diagnosis of this complication and establish individualized treatment based on endovascular procedures for each patient.

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“…Endovascular management showed remarkable improved outcomes when performed on suitable candidates [4 , 11 , 19] . Embolization procedures are now the most performed endovascular management of CBS.…”

Section: Cbs After Head and Neck Surgerymentioning

confidence: 99%

Transarterial embolization of acute carotid blowout syndrome postneck dissection

Ismail

Alhajri

Ibrahim

2020

Radiology Case Reports

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Carotid blowout syndrome is described as rupture of the carotid artery most commonly following head and neck dissection. It is an uncommon complication that can be fatal if not diagnosed and managed promptly. This report will discuss the case of a 45-year-old male, who developed carotid blowout syndrome following receiving several therapies for his laryngeal cancer. It will include how careful assessment of the patient's current state and taking into consideration his previous history and risk factors can lead to a case-tailored management plan to be performed in a timely manner, maximizing the chances of a successful life-saving procedure.

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CT Angiography Findings in Carotid Blowout Syndrome and Its Role as a Predictor of 1-Year Survival

Cited by 37 publications

References 20 publications

Endovascular Management of Post-Irradiated Carotid Blowout Syndrome

Endovascular Management of Post-Irradiated Carotid Blowout Syndrome

Carotid blowout syndrome: modern trends in management

Transarterial embolization of acute carotid blowout syndrome postneck dissection

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