Endovascular management of the carotid blowout syndrome: a single-center experience

Carotid Blowout Syndrome in Head and Neck Cancer Patients: Management of Patients At Risk for CBS

“…4,12,14,19,[25][26][27]30,33,39,42,45,48 Eight articles reported intubating patients, 8 articles reported placing new tracheotomies, and 3 articles reported using existing tracheotomies. 4,12,14,19,25,26,30,39,42,45,48 Control of acute hemorrhage with nasal packing was reported in 5 studies. 12,25,26,45,48 Blood products were given in 4 studies.…”

“…Carotid blowout syndrome (CBS) is a life-threatening complication affecting patients with a history of head and neck cancer. [1][2][3][4][5] By definition, CBS is a hemorrhagic event of the internal or external carotid artery systems. 2,[6][7][8] Three separate types of CBS have been identified in the literature, including threatened, impending, and acute.…”

“…Acute CBS is a life-threatening large-volume hemorrhage. 1,3,4,[6][7][8][9][10][11][12][13][14][15][16][17][18] The identification of patients at risk for CBS allows for the preparation of life-saving interventions.…”

“…Prior literature suggests head and neck cancer patients are at risk for CBS if they have a history of radiation therapy, deep neck surgery, or wound complications including mucocutaneous fistula. 1,2,4,8,10,11,13,15,16,[19][20][21][22][23][24][25][26][27][28] Patients presenting with CBS require immediate intervention of acute hemorrhages to prevent severe neurologic morbidity and mortality. [1][2][3][4]11,12,15,16,20,23,24,[27][28][29][30][31][32][33][34][35][36][37] Current treatments include supportive measures, surgical ligation of involved vasculature, and minimally invasive endovascular procedures.…”

Oncologic surgical resection with intravascular covered stent placement in patients with carotid artery encased by metastatic cancer—Our experience with 5 patients

“…The 5‐year survival rate is about 5%–13% 1 partly due to risks of stroke or carotid blowout syndrome (CBS). Previous approaches to the prevention of CBS (eg surgical ligation, endovascular embolisation and covered stent implantation) were palliative, and most reports did not further solve the tumour burden 2–4 . Simple surgical management, for example peeling the tumour off the carotid wall, resection with ligation of the carotid artery, resection with or without revascularisation, results in non‐complete resection or intraoperative and postoperative complications, even the difficulty of the operation is a significant challenge for the surgeon 1,5,6 .…”