Endovascular Treatment for Carotid Blowout Syndrome after Radiation: A Case Report

Abstract

Carotid blowout syndrome is one of the most complex bleeding complications that may occur in head and neck cancers patients. The purpose of this paper is to report the clinical manifestations and endovascular management of a case of patient with neck malignancies and a history of radiotherapy. The patient underwent immediate covered stent deployment which resulted in the successful control of bleeding.

Concurrent palliative care in the surgical management of head and neck cancer

“…Regional metastases in the cervical lymph nodes and locally advanced disease in the pharynx and at the skull base can encase and erode into the great vessels of the neck. The internal jugular vein will typically collapse and occlude without ill effect, but the carotid artery system, if broached can lead to exsanguinating hemorrhage, the dreaded “carotid blowout.” Endovascular techniques such as embolization or more recently, covered stenting have provided significant temporization of such bleeds . This can have the good result of diverting death to another more acceptable cause (such as hypercalcemia of malignancy).…”