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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
Author(s) -
Wong Daniel J. Y.,
Donaldson Christopher,
Lai Leon T.,
Coleman Andrew,
Giddings Charles,
Slater LeeAnne,
Chandra Ronil V.
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25018
Subject(s) - medicine , embolization , stent , internal carotid artery , radiology , surgery , stroke (engine) , endovascular treatment , carotid stenting , common carotid artery , carotid arteries , aneurysm , mechanical engineering , carotid endarterectomy , engineering
Background Indications for treatment and outcomes after endovascular management of carotid blowout syndrome for patients with head and neck cancer are not well defined. We investigated the safety and effectiveness of endovascular embolization and stent‐graft reconstruction. Methods A literature review was performed for studies published between 2001 and 2015 with relevance to treatment outcomes. Our institutional database was examined to identify patients treated with endovascular techniques. Results A total of 266 patients were included. Rates of procedural stroke were higher after embolization of internal carotid artery (ICA)/common carotid artery (CCA) compared to stent graft (embolization 10.3%; stent graft 2.5%; P < .02). Stent graft of ICA/CCA was associated with higher rates of recurrent bleeding (embolization 9.1%; stent graft 31.9%; P < .01). Conclusion Both embolization and stent grafts are safe therapeutic options for acute carotid blowout syndrome. Embolization for ICA/CCA carotid blowout syndrome was associated with higher risks of procedural stroke and lower recurrent bleeding compared to stent grafts.