Endovascular Management of Hemorrhage in Patients With Head and Neck Cancer

Two cases of emergent endovascular treatment for carotid blowout syndrome after free flap reconstruction for neck cancer

“…Those patients for whom a balloon occlusion test is unsuccessful or impossible may benefit from endovascular treatment, including stent placement and coil embolization of the pseudoaneurysm, which are alternatives to surgical treatment (Morrissey et al, 1997;Mazumdar et al, 2009). Carotid blowout is a life-threatening incident and initial ICA occlusion may be a therapeutic option to save a patient with massive bleeding.…”

Transcutaneous arterial embolization to control massive tumor bleeding in head and neck cancer: 63 patients’ experiences from a single medical center

“…Thirdly, TAE can have side effects, including neurological defects, contrastrelated nephrotoxicity, or anaphylactic reaction. Neurological defect was most likely if the internal carotid artery was embolized, in which case, the incidence was as high as 10% of cases [5,6,10,11,18]. Fourthly, the angiographic procedure is technique-dependent, and more aggressive embolization procedures should be performed only by an experienced radiologist.…”

“…Rebleeding is frequently encountered if no effective antitumor therapy is given. Many articles have reported successful transcutaneous arterial embolization (TAE) for hemorrhage in patients with head and neck tumors [4][5][6][7][8][9][10][11][12][13]. Kakizawa et al [4] treated ten patients with oral bleeding from HNC, but three patients needed a second TAE because of recurrent tumor bleeding.…”

Delayed carotid artery rupture in advanced cervical cancer – a dilemma in emergency management

“…In the primary setting, treatment options include irradiation, palliative peeling of tumor from the artery and resection with ligation or in-line grafting [4,8,9,10,12,13,14]. Earlier reports have favored ligation.…”

“…It has been reported to occur in 3-5% of major head and neck cancer resections [1,2,3,4,5,6,7,8,9,10,11,12,13]. It may also occur after radiotherapy.…”