Endovascular management of intracranial carotid blowout syndrome in patients with head and neck cancer

被引:0
|
作者
Yu, Kai-Wei [1 ]
Ling, Kan [2 ]
Wu, Chia-Hung [1 ,3 ]
Lin, Te-Ming [1 ]
Tai, Wei-An [1 ]
Yang, Chung-Han [1 ]
Kang, Yu-Mei [4 ]
Luo, Chao-Bao [1 ]
Chang, Feng-Chi [1 ,3 ]
机构
[1] Taipei Vet Gen Hosp, Dept Radiol, Taipei, Taiwan
[2] Taipei Med Univ, Shuang Ho Hosp, Dept Radiol, New Taipei City, Taiwan
[3] Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei, Taiwan
[4] Taipei Vet Gen Hosp, Dept Heavy Particles & Radiat Oncol, Taipei, Taiwan
关键词
Intervention; Stent; Tumor; COVERED STENT; NASOPHARYNGEAL CARCINOMA; ARTERY; PSEUDOANEURYSM;
D O I
10.1136/jnis-2024-022221
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Background Carotid blowout syndrome is a serious complication of head and neck cancer (HNC) that may involve the intracranial or extracranial internal carotid artery (ICA). Although parent artery occlusion (PAO) is the major endovascular treatment for intracranial carotid blowout syndrome (iCBS), the efficacy of using a balloon-expandable coronary stent-graft (BES) remains unclear.Methods This was a quasi-randomized trial, prospective study that included patients with iCBS treated by BES or PAO between 2018 and 2024. Patients were allocated to either group based on the last digit of their chart number; even numbers went to the BES group and odd numbers to the PAO group. The inclusion criteria of iCBS included the pathological process of CBS involving petrous and/or cavernous ICA detected by both imaging and clinical features. The primary outcome was defined as rebleeding events after intervention. The secondary outcome was defined as neurological complication after intervention.Results Fifty-nine patients with 61 iCBS lesions were enrolled. Thirty-three iCBS lesions were treated with BES and 28 underwent PAO. The results for the BES group versus the PAO group, respectively, were: rebleeding events, 5/33 (15.1%) vs 5/28 (17.8%) (p=0.78); neurological complication, 5/33 (15.1%) vs 5/28 (17.8%) (p=0.78); median hemostatic time (months), 10.0 vs 11.5 (p=0.22); and median survival time (months), 10.0 vs 11.5 (p=0.39).Conclusions No significant difference in rebleeding risk or neurological complication was observed between the BES and PAO groups. Our study confirmed the safety and effectiveness of applying BES for iCBS in HNC patients.
引用
收藏
页数:7
相关论文
共 50 条
  • [1] Endovascular management of carotid blowout syndrome in patients with head and neck cancers
    Roh, Jong-Lyel
    Suh, Dae Chu
    Kim, Mi Ra
    Lee, Jeong Hyun
    Choi, Jin Woo
    Choi, Seung-Ho
    Nam, Soon Yuht
    Kim, Sang Yoon
    ORAL ONCOLOGY, 2008, 44 (09) : 844 - 850
  • [2] Carotid Blowout Syndrome in Head and Neck Cancer Patients: Management of Patients At Risk for CBS
    Slijepcevic, Allison A.
    Roh, Joseph
    Pipkorn, Patrik
    Lipsey, Kim
    Bradley, Joseph P.
    LARYNGOSCOPE, 2023, 133 (03): : 576 - 587
  • [3] Evaluation of the outcomes of endovascular management for patients with head and neck cancers and associated carotid blowout syndrome of the external carotid artery
    Chang, F. -C.
    Luo, C. -B.
    Lirng, J. -F.
    Lin, C. -J.
    Wu, H. -M.
    Hung, S. -C.
    Guo, W. -Y.
    Teng, M. M. H.
    Chang, C. -Y.
    CLINICAL RADIOLOGY, 2013, 68 (11) : E561 - E569
  • [4] Carotid Blowout in Patients With Head and Neck Cancer
    Powitzky, Rosser
    Vasan, Nilesh
    Krempl, Greg
    Medina, Jesus
    ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 2010, 119 (07): : 476 - 484
  • [5] Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer
    Liang, Nathan L.
    Guedes, Brian D.
    Duvvuri, Umamaheswar
    Singh, Michael J.
    Chaer, Rabih A.
    Makaroun, Michel S.
    Sachdev, Ulka
    JOURNAL OF VASCULAR SURGERY, 2016, 63 (06) : 1525 - 1530
  • [6] Complication of head and neck cancer: Carotid blowout syndrome
    Jonas, Kenlee
    Meers, Aaron
    Gao, Matthew
    AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2024, 77 : e5 - e6
  • [7] Extracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer - Related Carotid Blowout Syndrome
    Wu, Ping-An
    Yuan, Guo-Yan
    Zhou, Ru-Ming
    Ho, Wilson Wai-Shing
    Lu, Zhao-Qun
    Cai, Ji-Fu
    Yang, Si-Yi
    Tsang, Raymond King-Yin
    Chan, Jimmy Yu-Wai
    LARYNGOSCOPE, 2021, 131 (07): : 1548 - 1556
  • [8] Endovascular therapy for the carotid blowout syndrome in head and neck surgical patients: Diagnostic and managerial considerations
    Chaloupka, JC
    Putman, CM
    Citardi, MJ
    Ross, DA
    Sasaki, CT
    AMERICAN JOURNAL OF NEURORADIOLOGY, 1996, 17 (05) : 843 - 852
  • [9] Endovascular management of carotid blowout syndrome
    Nas, Omer F.
    Kandemirli, Sedat G.
    Korkmaz, Baris
    Inecikli, Mehmet F.
    Oztepe, Muhammed F.
    Bilgin, Cem
    Hakyemez, Bahattin
    NEUROLOGICAL RESEARCH, 2025,
  • [10] Endovascular management of the carotid blowout syndrome
    Broomfield, S. J.
    Bruce, I. A.
    Luff, D. A.
    Birzgalis, A. R.
    Ashleigh, R. J.
    JOURNAL OF LARYNGOLOGY AND OTOLOGY, 2006, 120 (08): : 694 - 697