Endovascular therapy for management of oral hemorrhage in malignant head and neck tumors.
OBJECTIVE
To evaluate the efficacy and safety of endovascular therapy in oral hemorrhage from malignant head and neck tumors.


METHODS
Ten patients (mean age 56 years) with oral hemorrhage caused by malignant head and neck tumors underwent a total of 13 emergency embolization procedures using gelatin sponge particles, steel and/or platinum coils, or a combination of these embolic materials. Angiographic abnormalities, technical success rate, clinical success rate, recurrence rate, complications, hemostatic period, hospital days, survival days, and patient outcome were all analyzed.


RESULTS
Angiographic abnormalities were identified during 85% of procedures (11/13). The technical success rate was 100% (13/13 procedures). The primary and secondary clinical success rates were 77% (10/13 procedures) and 67% (2/3 procedures), respectively. The overall clinical success rate was 92%, and the recurrence rate was 22% (2/9 procedures) in patients whom we were able to observe during the 1-month period after embolization. No major complications occurred. Several patients in whom gelatin sponge particles had been used complained of transient local pain after the procedure. The median hemostatic period was 71 days (range 0-518 days). Median hospital and survival days were 59 days (range 3-209 days) and 141 days (range 4-518 days), respectively. Three patients survived and 7 patients died during the observation period. Only 1 of these 7 patients died from hemorrhage.


CONCLUSIONS
In conclusion, our findings suggest that endovascular therapy is an effective, safe, and repeatable treatment for oral hemorrhage caused by malignant head and neck tumors.
Kakizawa
Hideaki
H
Department of Radiology, Division of Medical Intelligence and Informatics Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, 734-8551, Japan. kakizawa@hiroshima-u.ac.jp
Toyota
Naoyuki
N
Naito
Akira
A
Ito
Katsuhide
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000009:adverse effects / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006490:Hemostatics / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008223:Lymphoma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000628:therapy; D006472:Oral Hemorrhage / Q000209:etiology / Q000628:therapy*; D010984:Platinum / Q000009:adverse effects / Q000627:therapeutic use; D011859:Radiography; D012189:Retrospective Studies; D055502:Secondary Prevention; D013232:Steel / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome
D006490:Hemostatics; D013232:Steel; D010984:Platinum