Abstract
Background
Carotid blowout syndrome (CBS) is a life-threatening disease characterized by compromise
of the carotid artery by head and neck cancer (HNC).
Materials and methods
We reviewed the characteristics and outcomes of all patients with carotid blowout
syndrome who were treated between April 2010 and December 2019. Twelve patients with
a history of HNC and radiation therapy were investigated. The balloon occlusion test
(BOT) was performed in all patients to confirm collateral circulation. We placed a
stent in patients who were intolerant to the BOT.
Results
The patients’ ages ranged from 50 to 81 years (mean: 68.1 years). Therapeutic occlusion
of the affected internal carotid artery was performed in nine patients, while stenting
was performed in three patients. Immediate hemostasis was achieved in all patients.
Patients treated using stents were administered perioperative DAPT. One patient experienced
rebleeding after surgery. Two patients had procedure-related cerebral infarctions.
One patient died, but the others survived without major neurological deficits. One
patient had persistent aneurysm after surgery that resolved over time.
Conclusion
Endovascular treatment via occlusion or stent-based reconstruction of the internal
carotid artery resulted in immediate hemostasis. Carotid occlusion and covered stent
application are safe and efficient techniques to treat CBS secondary to HNC. Surgeons
may obtain better outcomes if they perform BOT before occlusion and design treatment
accordingly.
Key Words
Abbreviation:
CBS (Carotid blowout syndrome), HNC (Head and neck cancer), BOT (Balloon occlusion test), DSA (Digital subtraction angiography), CT (Computed tomography), ICA (Internal carotid artery), CCA (Common carotid artery)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 25, 2021
Accepted:
April 3,
2021
Received in revised form:
March 24,
2021
Received:
January 4,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105818
Copyright
© 2021 Elsevier Inc. All rights reserved.
