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

Chou, Wen‐Chi; Lu, Chang‐Hsien; Lin, Gigin; Hong, Yushin; Chen, Ping‐Tsung; Hsu, Hung‐Chih; Chen, Jen‐Shi; Yeh, Kun‐Yun; Wang, Hung‐Ming; Liaw, Chuang-Chi

doi:10.1007/s00520-007-0234-y

Cited by 18 publications

(20 citation statements)

References 15 publications

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“…The MST was 263 days, which is longer than those reported previously (26-141 days). 1,2,10 Tumor bleeding associated with HNC is a fatal event. Not only hemorrhagic shock but also airway obstruction due to hematoma can be life-threatening within a few minutes after the onset.…”

Section: Patient Outcome (Analysis Of 31 Patients)mentioning

confidence: 99%

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Transarterial Embolization for Bleeding in Patients with Head and Neck Cancer: Who Benefits?

et al. 2021

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Objectives/Hypothesis: The present study aimed to investigate the efficacy of transarterial embolization (TAE) for bleeding in patients with head and neck cancer (HNC) and to evaluate the prognostic factors after TAE.Study design: Outcome study.Methods: This retrospective study included 31 consecutive patients (27 men and 4 women; median age, 61 years) who presented uncontrollable hemorrhage associated with HNC and underwent emergency TAE at our institution during a 10-year period (January 2011-December 2020). This corresponded to 40 TAE procedures, including 27 cases with an unstable status (circulatory and/or respiratory insufficiency) and 10 cases with carotid blowout syndrome. The technical success rate and adverse events were analyzed on a per-procedure basis. The rebleeding and overall survival (OS) rates were analyzed on a per-patient basis, and the factors related to OS were evaluated.Results: The technical success rate was 100%. As an adverse event, cerebral infarction was found in three cases with carotid blowout syndrome. The rebleeding rate at 30 days after TAE and in the follow-up period (range, 9-3,004 days) was 17.2% and 35.5%, respectively. The median survival time was 263 days (95% confidence interval: 124.0-402.0 days). In the log-rank test, complete remission (CR) of the primary cancer at the time of the first TAE was identified as a significant influencing factor of survival.Conclusion: TAE is effective for the treatment of hemorrhage associated with HNC even in patients with an unstable status. Patients with CR can gain a long life span.

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Section: Patient Outcome (Analysis Of 31 Patients)mentioning

confidence: 99%

“…It occurs as a complication of surgery and chemoradiation therapy, and as direct bleeding from HNC itself. [1][2][3] It can lead to catastrophic hemorrhagic shock and airway obstruction. Moreover, carotid blowout syndrome (CBS), which refers to carotid artery rupture, can be rapidly fatal with high mortality rates of up to 40%.…”

Section: Introductionmentioning

confidence: 99%

Transarterial Embolization for Bleeding in Patients with Head and Neck Cancer: Who Benefits?

et al. 2021

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“…This occurs frequently in patients with ulcerative tumours, due to vessel erosion by malignancy. Management is initially conservative, with local packing, but transarterial embolisation has been used with success 13 . Surgical treatment can be difficult, because of factors such as fistulae and radiation-induced necrosis, and is associated with a high mortality and complication rate.…”

Section: Tumour Haemorrhagementioning

confidence: 99%

“…Arterial embolisation offers an effective, safe, fast method for controlling bleeding from tumours 15 . Transarterial embolisation has been reported to have a success rate of 92 per cent, 14 as well as producing an average post-haemorrhage survival of 26 days, compared with 8 days in patients receiving angiography alone 13 …”

Section: Tumour Haemorrhagementioning

confidence: 99%

The role of embolisation in ENT: an update

2011

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“…Multiple retrospective series have documented the safety and efficacy of embolization, although the procedure is primarily palliative given the mortality associated with the severity of underlying disease. [99][100][101][102][103][104] Rupture of the proximal carotid arteries related to malignancy is referred to as carotid blowout syndrome (CBS). Carotid occlusion and stent-graft techniques have both been employed with success, although rebleeding, stroke, carotid thrombosis, and infection have complicated outcomes.…”

Section: Epistaxismentioning

confidence: 99%

Embolization in the Head and Neck

Cooke¹,

Ghodke²,

Natarajan³

et al. 2008

Semin intervent Radiol

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In this article, we review current practices in therapeutic embolization of the head and neck. Major applications including vascular malformations, highly vascular tumors, trauma, and other sources of hemorrhage are discussed. We emphasize the importance of a thorough knowledge of head and neck vascular anatomy, especially of potential connections to critical territories not intended for embolization. The choice of embolic agent and its effect on safety and efficacy of treatment are presented. KEYWORDS:Intervention, head and neck, vascular malformation, tumor, bleedingObjectives: On completion of this article, the reader should (1) appreciate the importance of preprocedural evaluation of vascular anatomy of the head and neck, (2) be familiar with important potential collateral pathways posing risk in intervention, and (3) understand basic principles of intervention in the head and neck. Accreditation: Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit: TUSM designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit TM . Physicians should only claim credit commensurate with the extent of their participation in the activity.Intricate anatomy greatly complicates the diagnostic and therapeutic management of head and neck pathology. Intimate anatomic relationships provide risks of visual loss, cranial nerve injury, and airway compromise related to treatment. Advances in endovascular techniques have expanded the role for catheter-based therapies beyond acute hemorrhage and into secondary and primary treatment of vascular anomalies and tumors of the face, neck, and skull base. This article is a concise review of the current practices in endovascular management of head and neck pathologies. ANATOMYThe embryonic development of the great vessels is a complex process involving the formation and regression of six paired arterial arches, creating the internal and external carotid arteries. The vascular commonalities during this process create redundancy in external and internal distributions, as well as varying degrees of interconnection between the external and internal and the anterior and posterior cerebral circulation. [1][2][3] As an operator, a firm understanding of these collateral pathways and potential anastomoses is paramount to the safety and efficacy of head and neck intervention. For the purposes of this article, we will limit discussion to extracranial and skull base vasculature. INTERNAL CAROTID ARTERYThe internal carotid artery (ICA) is a terminal branch of the common carotid artery that originates at the level of

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

Abstract: In our hands, TAE was associated with a low incidence of toxicities commonly attributable to the procedure such as stroke. Patients who were able to undergo TAE lived longer than those who were not candidates for the procedure.

Cited by 18 publications

References 15 publications

Transarterial Embolization for Bleeding in Patients with Head and Neck Cancer: Who Benefits?

Transarterial Embolization for Bleeding in Patients with Head and Neck Cancer: Who Benefits?

The role of embolisation in ENT: an update

Embolization in the Head and Neck

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