Endovascular Management of Post-Irradiated Carotid Blowout Syndrome

被引:50
|
作者
Chang, Feng-Chi [1 ,2 ]
Luo, Chao-Bao [1 ,2 ]
Lirng, Jiing-Feng [1 ,2 ]
Lin, Chung-Jung [1 ,2 ]
Lee, Han-Jui [1 ,2 ]
Wu, Chih-Chun [1 ,2 ]
Hung, Sheng-Che [1 ,2 ]
Guo, Wan-Yuo [1 ,2 ]
机构
[1] Taipei Vet Gen Hosp, Dept Radiol, Taipei, Taiwan
[2] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan
来源
PLOS ONE | 2015年 / 10卷 / 10期
关键词
CANCER-PATIENTS; NECK CANCERS; HEAD; ARTERY; OCCLUSION; REIRRADIATION; EXPERIENCE; OUTCOMES; RISK;
D O I
10.1371/journal.pone.0139821
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Purpose To retrospectively evaluate the clinical and technical factors related to the outcomes of endovascular management in patients with head-and-neck cancers associated with post-irradiated carotid blowout syndrome (PCBS). Materials and Methods Between 2000 and 2013, 96 patients with PCBS underwent endovascular management. The 40 patients with the pathological lesions located in the external carotid artery were classified as group 1 and were treated with embolization. The other 56 patients with the pathological lesions located in the trunk of the carotid artery were divided into 2 groups as follows: group 2A comprised the 38 patients treated with embolization, and group 2B comprised the 18 patients treated with stent-graft placement. Fisher's exact test was used to examine endovascular methods, clinical severities, and postprocedural clinical diseases as predictors of outcomes. Results Technical success and immediate hemostasis were achieved in all patients. The results according to endovascular methods (group 1 vs 2A vs 2B) were as follows: technical complication (1/40[2.5%] vs 9/38[23.7%] vs 9/18[50.0%], P = 0.0001); rebleeding (14/40[35.0%] vs 5/38[13.2%] vs 7/18[38.9%]), P = 0.0435). The results according to clinical severity (acute vs ongoing PCBS) were as follows: technical complication (15/47[31.9%] vs 4/49 [8.2%], P = 0.0035); rebleeding (18/47[38.3%] vs 8/49[16.3%], P = 0.0155). The results according to post-procedural clinical disease (regressive vs progressive change) were as follows: alive (14/21[66.7%] vs 8/75[10.7%], P<0.0001); survival time (34.1 +/- 30.6[0.3-110] vs 3.6 +/- 4.0[0.07-22] months, P<0.0001). Conclusion The outcomes of endovascular management of PCBS can be improved by taking embolization as a prior way of treatment, performing endovascular intervention in slight clinical severity and aggressive management of the post-procedural clinical disease.
引用
收藏
页数:12
相关论文
共 50 条
  • [21] Carotid blowout syndrome: endovascular management of a lesser known oncological emergency: case report
    Jitender Singh
    Tarika Sharma
    Taraprasad Tripathy
    Egyptian Journal of Radiology and Nuclear Medicine, 52
  • [22] Carotid blowout syndrome: endovascular management of a lesser known oncological emergency: case report
    Singh, Jitender
    Sharma, Tarika
    Tripathy, Taraprasad
    EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE, 2021, 52 (01):
  • [23] Emergent endovascular treatment with direct carotid puncture for exsanguinating Carotid Blowout Syndrome
    Wang, H
    Fraser, K
    Bortolotti, C
    Lanzino, G
    NEUROCRITICAL CARE, 2005, 2 (02) : 176 - 178
  • [24] Emergent endovascular treatment with direct carotid puncture for exsanguinating carotid blowout syndrome
    Huan Wang
    Kenneth Fraser
    Carlo Bortolotti
    Giuseppe Lanzino
    Neurocritical Care, 2005, 2 : 176 - 178
  • [25] Endovascular treatment of carotid blowout syndrome: who and how to treat
    Patsalides, A.
    Fraser, J. F.
    Smith, M. J.
    Kraus, D.
    Gobin, Y. P.
    Riina, H. A.
    JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2010, 2 (01) : 87 - 93
  • [26] Carotid Blowout Management in the Endovascular Era: A Single Institution Series
    Weinberg, Joshua
    Sweid, Ahmad
    Joffe, Daniel
    Piper, Keenan
    Abbas, Rawad
    Hussain, Zubin
    Anderson, Brigitte
    Gooch, M. Reid
    Herial, Nabeel
    Tjoumakaris, Stavropoula I.
    Hasan, David M.
    Zarzour, Hekmat
    Rosenwasser, Robert H.
    Jabbour, Pascal
    NEUROSURGERY, 2020, 67 : 123 - 123
  • [27] Carotid blowout syndrome: modern trends in management
    Suarez, Carlos
    Fernandez-Alvarez, Veronica
    Hamoir, Marc
    Mendenhall, William M.
    Strojan, Primoz
    Quer, Miquel
    Silver, Carl E.
    Rodrigo, Juan P.
    Rinaldo, Alessandra
    Ferlito, Alfio
    CANCER MANAGEMENT AND RESEARCH, 2018, 10 : 5617 - 5628
  • [28] 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
  • [29] Endovascular Treatment of Carotid Artery Blowout Syndrome Caused by Oropharyngeal Carcinoma
    Ergun, Onur
    Celtikci, Pinar
    Durmaz, Hasan Ali
    Birgi, Erdem
    Hekimoglu, Baki
    INTERVENTIONAL NEURORADIOLOGY, 2014, 20 (04) : 510 - 513
  • [30] Carotid blowout syndrome
    Lin, Yung-Shang
    Wang, Chia-Ti
    Chen, Yen Ting
    Chen, Kuo-Tai
    ULUSAL TRAVMA VE ACIL CERRAHI DERGISI-TURKISH JOURNAL OF TRAUMA & EMERGENCY SURGERY, 2015, 21 (01): : 68 - 70