Endovascular Management of Impending Carotid Rupture in a Patient with Advanced Head and Neck Cancer

Bates, Mark C.; Shamsham, Fadi

doi:10.1177/152660280301000112

Cited by 22 publications

(21 citation statements)

References 13 publications

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“…Use of many types of stent grafts, from homemade to commercially available devices, has been described in numerous case reports and reports on small series of patients. [2][3][4][5][6][7][8][9][10][11] In 1992, we began to employ homemade covered stents and then stent grafts from several manufacturers to treat PAs and AVF in the CA. We describe our results with this treatment in a multicenter series in which the maximum follow-up time was 13 years.…”

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confidence: 99%

Stent-Graft Treatment of Pseudoaneurysms and Arteriovenous Fistulae in the Carotid Artery

et al. 2006

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The purpose of this study was to assess the safety and efficacy of stent-graft placement in the management of arteriovenous fistulae (AVF) and pseudoaneurysms (PAs) involving the carotid artery (CA). Twenty-two patients (16 men, 6 women) with a CA AVF (n = 5) or PA (n = 17) owing to a gunshot or stab wound, carotid endarterectomy, blunt trauma, a tumor, spontaneous dissection, or a central venous catheter were treated with percutaneous placement of stent grafts. The patients presented with tumor, bruit, headache, mouth and tracheostomy bleeding, transitory hemiparesis, seizure, or stroke. Diagnoses were made by using computed tomographic angiography (CTA) and digital subtraction angiography. Fourteen lesions were in the common CA; eight were in the internal CA. Homemade devices and stent grafts from a variety of manufacturers were employed. Follow-up evaluations included clinical, CTA, and Doppler ultrasound assessments. All patients had resolution of the PA or AVF. In one patient with a large petrous PA, acute occlusion of the CA developed after placement of three balloon-expandable stent grafts, but there were no neurologic complications because the circle of Willis was functional. During follow-up ranging from 2 months to 13 years, asymptomatic 90% stenosis owing to stent compression was observed on Doppler ultrasound and angiographic examinations in a patient with an autologous vein-covered stent graft in the internal CA. Three other patients died of causes unrelated to stent-graft placement. In all other patients, the stent graft remained patent. Our results indicate that stent grafting is an acceptable alternative to surgery in the treatment of AVF and PAs in the CA.

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Stent-Graft Treatment of Pseudoaneurysms and Arteriovenous Fistulae in the Carotid Artery

et al. 2006

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“…17). The incidence of this complication is low in cervicofacial surgery (4.3%) [17] although external radiotherapy increases the risk by a factor of 7.6 [18,19].…”

Section: Embolization Of Branches Of the External Carotid Artery In Ementioning

confidence: 99%

“…Occasionally, hemorrhage in the postoperative period may be due to loosening of a vascular structure (reconstruction flap). Endovascular (hemostatic) treatment is an option with a recognized indication [18]. The general principles of embolizing branches of the external carotid artery are the same as for essential epistaxis (Appendix).…”

Section: Embolization Of Branches Of the External Carotid Artery In Ementioning

confidence: 99%

Epistaxis: The role of arterial embolization

Reyre

Michel

Santini

et al. 2015

Diagnostic and Interventional Imaging

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Epistaxis is defined as flow of blood from the nasal fossae and is a common and benign disorder in the great majority of cases which does not require medical care. It may however become a genuine medical or surgical emergency because of the amount, repeated episodes or patient's medical vulnerability (such as coronary artery disease patients). Epistaxis may be either primary or a symptom of an underlying disease. Four levels of problems need to be answered faced with epistaxis: recognizing it, and in particular not missing "epistaxis" due to swallowed blood or venous hemorrhage, which falls outside of the scope of interventional radiology; establishing the amount and its repercussions, particularly as a decompensating factor in another disease; investigating its cause and in particular never missing a tumor (male adolescents); obtaining hemostasis. Epistaxis varies not only in type and cause but must be considered in its clinical context. Arterial embolization is a treatment of choice for severe refractory epistaxis and some hemorrhages. When carried out by trained operators, it is an effective method with few risks of complications and is increasingly being used in reference centers (Brinjikji et al.). It remains, however, a method which is less widely used than surgery, particularly in the United States where in a series of 69,410 patients treated over the last 10 years for refractory epistaxis, 92.6% underwent surgical ligation, 6.4% embolization and 1% combined treatments (Brinjikji et al.). Epistaxis is occasionally catastrophic and requires extremely urgent management. In each case, close collaboration with the surgeon, the presence of an intensive care anesthetist and at least sedation are all factors which improve management and therefore the results of embolization. All patients and/or their friends/close family should have given "reliable, clear and appropriate" information.

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“…Rarement en postopératoire immédiat, l'hémorragie peut être secondaire à un lâchage de suture vasculaire (lambeau de reconstruction). Le traitement endovasculaire (hémostatique) est une option thérapeutique dont l'indication est reconnue [19]. Les principes généraux de l'embolisation des branches de la carotide externe sont les mêmes que pour les épistaxis essentielles (cf.…”

Section: éPistaxis Secondairesunclassified

Épistaxis, du diagnostic à la thérapeutique

Reyre

Michel

Santini

et al. 2015

Journal de Radiologie Diagnostique et Interventionnelle

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Endovascular Management of Impending Carotid Rupture in a Patient with Advanced Head and Neck Cancer

Abstract: Stent-grafts in combination with coil embolization can be used to manage patients with impending carotid rupture secondary to head and neck cancer.

Cited by 22 publications

References 13 publications

Stent-Graft Treatment of Pseudoaneurysms and Arteriovenous Fistulae in the Carotid Artery

Stent-Graft Treatment of Pseudoaneurysms and Arteriovenous Fistulae in the Carotid Artery

Epistaxis: The role of arterial embolization

Épistaxis, du diagnostic à la thérapeutique

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