Elective Carotid Artery Ligation in the Treatment of Advanced Cancer of the Head and Neck

James, Norman J.; STUTEVIIXE, ORION H.; Tasche, Conrad; Stuteville, Orion H.

doi:10.1097/00006534-197103000-00008

Plastic and Reconstructive Surgery

1971

DOI: 10.1097/00006534-197103000-00008

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Elective Carotid Artery Ligation in the Treatment of Advanced Cancer of the Head and Neck

Norman J. James

ORION H. STUTEVIIXE

Conrad Tasche

et al.

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1977

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Cited by 18 publications

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“…Haemorrhage from the common or internal carotid arteries can only be stopped by immediate intervention with emergency ligation. The survival rate ranges between 30 per cent and 40 per cent (Conley, 1953;Ghandi and Oppenheimer, 1962;James et al, 1971;Ketcham and Hoye, 1965;Martinez et al, 1975;Moore and Baker, 1955;Moore et al, 1969;Payan, 1967;Swain et al, 1974).…”

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Rupture of supra-aortic neck arteries due to lesions caused by tracheal tubes

1984

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mentioning

confidence: 99%

Rupture of supra-aortic neck arteries due to lesions caused by tracheal tubes

1984

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The Importance of Tumor Attachment to the Carotid Artery

Kennedy¹,

Krause²,

Loevy³

1977

Arch Otolaryngol

114

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Transarterial Carotid Occlusion: Case Report and Review of the Literature

Jd¹,

Gd²

1984

Archives of Otolaryngology - Head and Neck Surgery

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\s=b\ Postoperative carotid artery rupture occurs in 3% to 4.5% of head and neck resections involving a mucosal primary and radical neck dissection. Other indications for carotid sacrifice-ligation include en bloc removal of the artery with tumor, inadvertent injury during surgery, and hemorrhage from vessel erosion by unresectable tumor. The mortality and morbidity of unilateral carotid occlusion are significantly decreased when performed electively in a hydrated and normotensive patient with a normal serum hemoglobin level. Sequelae approximate 5% when adequate collateral cerebral blood flow is present. A transarterial catheter approach to the measurement of carotid artery back pressure and permanent obstruction of flow in an awake patient is presented. (Arch Otolaryngol 1984;110:694-696) Carotid artery "blowout" is re¬ ported to follow 3% to 4.5% of head and neck resections involving a mucosal primary and radical neck dis¬ section, with approximately 80% occurring in previously irradiated patients.1·2 Five to six percent of head and neck carcinomas or their cervical métastases abut a common or internal carotid artery.34 Where a "curative peel"4 is not likely, brachytherapy with interstitial radioactive implan¬ tation of the pericarotid region may be helpful.5 En bloc resection of a carotid artery invaded by carcinoma may increase the cure rate, although the three-year survival of such patients is 7% to 10% despite aggres¬ sive therapy.24512 When interhemispheric cerebral blood flow is marginal and soft-tissue coverage is avail¬ able, the resected artery can be replaced by a synthetic or, preferably, a saphenous vein graft. Other indica¬ tions for carotid artery occlusion include hemorrhage from vessel ero¬ sion by unresectable tumor and inad¬ vertent damage during surgery.310 In 152 patients requiring carotid artery occlusion, Konno et al13 reported 59 resections for tumor extirpation, 64 ligations for actual or impending arte¬ rial rupture by terminal carcinomas, and 29 from postoperative wound complications.The carotid arteries supply 85% of the cerebral circulation, and occlusion of a common or internal carotid artery in the aging population carries a reported mortality of 14% to 64%, with emergent ligation being far more hazardous than planned occlusion.1·6·14 Moore et al15 reported carotid artery ligation in 151 patients, experiencing a 50% incidence of neurologic deficits and a 38% mortality in emergent pro¬ cedures a 23% morbidity and a 17% mortality in elective cases. Mainte¬ nance of BP, intravenous hydration, and blood replacement reduce the complication rate. When adequate col¬ lateral cerebral circulation is docu¬ mented prior to common-internal carotid artery occlusion, death or per¬ manent neurologic sequelae occur in 0% to 10% (median, 5%) of patients.811·1619 REPORT OF A CASEA 45-year-old man had a laryngectomy and right radical neck dissection for a T3 N2A MO squamous cell carcinoma, fol¬ lowed by 6,500 rad to both sides of the neck.Eleven months later tumor was present in the superior trac...

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Elective Carotid Artery Ligation in the Treatment of Advanced Cancer of the Head and Neck

Cited by 18 publications

References 0 publications

Rupture of supra-aortic neck arteries due to lesions caused by tracheal tubes

Rupture of supra-aortic neck arteries due to lesions caused by tracheal tubes

The Importance of Tumor Attachment to the Carotid Artery

Transarterial Carotid Occlusion: Case Report and Review of the Literature

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