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Semin intervent Radiol 2013; 30(03): 245-248
DOI: 10.1055/s-0033-1353477
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Interventional Management of Head and Neck Emergencies: Carotid Blowout

Richard A. Haas
1   Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
,
Sun Ho Ahn
1   Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
› Author Affiliations
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Publication History

Publication Date:
13 September 2013 (online)

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Abstract

Involvement of the carotid artery by malignant processes of the head and neck with compromise of vessel integrity and rupture—“carotid blowout syndrome” (CBS)—is one of the most devastating complications of malignancy. Most often, it is associated with squamous cell cancer and almost always in patients who have undergone prior radiation therapy. CBS is classified as threatened, impending, or acute. Bleeding into the oral cavity or from areas of skin breakdown is a frightening experience for patients and their families and often a terminal event. Prognosis is poor with up to 50% mortality and morbidity, and surgical options are limited and risky. Endovascular management with vessel sacrifice or stent placement has become the principle treatment option in this patient population, though still associated with procedural complications, often neurologic, that can occur acutely or in a delayed fashion. This article reviews techniques and outcomes associated with endovascular treatment of CBS.

Keywords

carotid blowout syndrome - carotid artery sacrifice - carotid artery covered stent - interventional radiology
 

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