The expanding role of interventional radiology in head and neck surgery

Contemporary management of carotid blowout syndrome utilizing endovascular techniques

“…Surgical ligation for the treatment of hemorrhage related to head and neck cancer historically carried a high mortality rates (40%) and major neurologic morbidity (60%). Over the last 2 decades, the use of endovascular techniques has revolutionized the treatment of CBS with a resultant drop in mortality and neurological morbidity . Management of acute CBS involves basic principles of resuscitation with establishment of airway, control of hemorrhage with manual pressure, and/or packing of the oropharynx or neck wound.…”

Stent grafts in patients with carotid blowout syndrome: Outcome and antiplatelet therapy in preventive versus emergency cases

“…Inclusion criteria included all current or previous head and neck malignancies, whereas exclusion criteria were other reasons of bleeding in the head and neck. Treatments were grouped into 3 categories: (1) threatened (group I); (2) imminent (group II); (3) and acute bleeding (group III) . All patient records were analyzed for primary tumor localization and TNM classification, therapy (surgery and/or adjuvant or definitive radio[chemo]therapy), medication, complications, and outcome.…”

“…Carotid blowout syndrome is a rare but severe complication, especially in patients with advanced head and neck cancers (3%‐4%) . It is a well‐known clinical picture that encompasses not only acute bleeding but also sentinel and threatening bleeding . The close relationship of the primary tumor and/or the lymph node metastasis to the common or internal carotid artery and cervical infections or necrosis attributable to radiotherapy may lead to a carotid blowout syndrome …”

“…1,2 It is a well-known clinical picture that encompasses not only acute bleeding but also sentinel and threatening bleeding. 3 The close relationship of the primary tumor and/or the lymph node metastasis to the common or internal carotid artery and cervical infections or necrosis attributable to radiotherapy may lead to a carotid blowout syndrome. 2,3 In the treatment of carotid blowout syndrome, surgical procedures with high mortality rates of up to 40% have been widely replaced by endovascular treatment.…”

“…3 The close relationship of the primary tumor and/or the lymph node metastasis to the common or internal carotid artery and cervical infections or necrosis attributable to radiotherapy may lead to a carotid blowout syndrome. 2,3 In the treatment of carotid blowout syndrome, surgical procedures with high mortality rates of up to 40% have been widely replaced by endovascular treatment. 4,5 With progress in surgical and adjuvant therapies, 6 the prognosis of head and neck cancer has improved.…”