An approach for acute disruption of large arteries in patients with advanced cervical cancer: endoluminal balloon occlusion technique.
OBJECTIVE
To test the feasibility of an intraluminal balloon occlusion technique for the control of sudden arterial disruption from cervical branches in patients with advanced malignancy.


BACKGROUND
A sudden disruption of large cervical arteries is a devastating complication of advanced cervical malignancy and local infection.


METHODS
Three patients with this complication underwent endoluminal balloon occlusion before surgical management. A double-lumen balloon catheter was introduced from the femoral artery to the bleeding point. Angiographic examination of the intracranial cross-filling could be performed by the injection of contrast medium from the opposite carotid artery, and consciousness levels could be directly confirmed under unilateral carotid occlusion.


RESULTS
Resection of the carotid or innominate artery was safely performed in all the patients. No neurologic complications occurred. Bleeding did not recur during follow-up (range 5-32 months).


CONCLUSIONS
This experience, although limited, suggests that surgical intervention to control cervical arterial bleeding with intraluminal balloon occlusion prevents excessive bleeding, decreases the risk of damage to the central nervous system, and improves the outcome in these critically ill patients.
Sakakibara
Y
Y
Department of Surgery and Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba Science City, Ibaraki, Japan.
Kuramoto
K
K
Jikuya
T
T
Sato
F
F
Nakamura
K
K
Abe
M
M
Mitsui
T
T
D000208:Acute Disease; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D016122:Brachiocephalic Trunk / Q000601:surgery*; D002339:Carotid Arteries / Q000601:surgery*; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications*; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011859:Radiography