Massive epistaxis related to petrous carotid artery pseudoaneurysm after radiation therapy: emergency treatment with covered stent in two cases.
Two patients had acute left carotid rupture from radiation therapy-induced pseudoaneurysms, resulting in hemodynamic collapse. Because the patients were semicomatose and in shock, an immediate salvage procedure was needed. Location of the pseudoaneurysm at the skull base made surgical treatment less possible. Endovascular therapy was the treatment of choice. Preserving patency of the carotid artery was a desirable option. The successful use of a covered stent in the emergency treatment of massive epistaxis due to active bleeding from pseudoaneurysm in the petrous internal carotid artery (ICA) is described.
Auyeung
Kai Ming
KM
Department of Radiology, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong SAR.
Lui
Wai Man
WM
Chow
Lawrence C K
LC
Chan
Fu Luk
FL
D017542:Aneurysm, Ruptured / Q000209:etiology / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D002343:Carotid Artery, Internal / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery; D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology* / Q000628:therapy; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D004638:Emergency Treatment; D004844:Epistaxis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000628:therapy; D010579:Petrous Bone / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery; D019291:Skull Base / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D015607:Stents; D014057:Tomography, X-Ray Computed
D020099:Coated Materials, Biocompatible