Covered stents safely utilized to prevent catastrophic hemorrhage in patients with advanced head and neck malignancy

Abstract

The use of covered stents for avoidance of catastrophic hemorrhage following treatment in patients with head and neck tumors with bilaterally threatened carotid arteries was successful.

Polytetrafluoroethylene‐covered nitinol stent graft for treatment of carotid artery blowout syndrome in head and neck cancer patients

“…This outcome's low complication rate is comparable with those reported in the literature (Table II) [6][7][8][9][10][11] and highlights the efficacy of using self-expandable stent grafts in emergency practice to achieve hemostasis and prevent the high neurologic morbidity (20%) associated with carotid occlusion. This outcome's low complication rate is comparable with those reported in the literature (Table II) [6][7][8][9][10][11] and highlights the efficacy of using self-expandable stent grafts in emergency practice to achieve hemostasis and prevent the high neurologic morbidity (20%) associated with carotid occlusion.…”

“…Although graft infection was commonly reported in the literature, 6,10,14,15 none occurred in our study despite a wound infection being present in three patients. This low rate (15%), compared to the Chang et al's series (40%), 10 7 where patients received optimal antithrombotic treatment (heparin and a bolus of aspirin and clopidogrel before stent implantation) and were maintained on lifelong dual antiplatelet medications; however, 80% of his their patients presented with post-treatment bleeding. We encountered three stent occlusions in our series with a mean of 2 months; all patients received heparin at the time of stent delivery and aspirin starting the day of stent implantation.…”

Safety and effectiveness of endovascular embolization or stent‐graft reconstruction for treatment of acute carotid blowout syndrome in patients with head and neck cancer: Case series and systematic review of observational studies

“…The MINORS quality scores ranged from 7 to 11. An overview of the characteristics of the studies is provided in Table …”

“…An overview of the characteristics of the studies is provided in Table 1. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Of the 292 patients, 26 patients did not have relevant or extractable data. Of the remaining 266 patients, 137 were treated with embolization (77 for ICA and/or CCA and 60 for ECA).…”

Carotid blowout syndrome: modern trends in management

“… 77 Other authors have also observed significantly lower rebleeding rates with embolization (11%–21%) compared with covered stents (25%–85%) ( Table 3 ). 1 , 22 , 28 , 69 , 70 , 73 , 78 – 86 Short- and long-term rebleeding after stent placement can occur from the stented carotid artery as a result of either persistent endoluminal leakage or involvement of the carotid artery with tumor either proximal or distal to the stent, as well as due to erosion of the arterial wall by the stent. Existence of an uncontrolled ongoing infection at the stent site is an important factor associated with recurrent CBS.…”