Abstract
Objective: The aim of the study was to determine outcomes after interventional radiology treatment of carotid blowout. Methods: Patients with head and neck cancer and who received interventional radiology treatment for carotid blowout between 2000 and 2022 were included. Pre-treatment, treatment, and post-treatment variables were evaluated. Results: Fourteen patients met inclusion criteria. Eleven patients (78.6%) had a history of radiation. Twelve (85.7%) blowouts occurred within 6 months of recent intervention. Initial treatment was with stenting (n = 9, 64.3%), coil embolization (n = 4, 28.6%), or both (n = 1, 7.1%). Six patients (42.9%) underwent subsequent carotid bypass. Morbidity following treatment included stroke (n = 1) and rebleeding (n = 4). Six-month survival was 57.1%. Of the patients who survived past six months, 5/8 were treated with carotid bypass and coverage. Four patients died of cancer progression, three of rebleeding, and three of medical complications. Conclusion: The majority of carotid blowout occurs within 6 months of surgery or radiation. Many who survive will die of cancer progression or medical illness. Carotid bypass with flap coverage may be a worthwhile treatment for carotid blowout and should be considered as an adjunct to endovascular treatment. Level of Evidence: 4 Laryngoscope, 134:695–700, 2024.
Original language | English (US) |
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Pages (from-to) | 695-700 |
Number of pages | 6 |
Journal | Laryngoscope |
Volume | 134 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2024 |
Keywords
- carotid blowout
- carotid replacement
- stenting
ASJC Scopus subject areas
- Otorhinolaryngology