title: Emergent endovascular treatment with direct carotid puncture for exsanguinating Carotid Blowout Syndrome.
abstract: BACKGROUND
  Carotid Blowout Syndrome (CBS) carries an exceedingly high mortality rate. Various established endovascular techniques are successful in treating less acute CBS, but exsanguinating patients with hemodynamic compromise continue to pose a significant clinical challenge.
  
  
  METHODS
  We report a 53-year-old male with squamous cell carcinoma of the anterior tongue presented with a sentinel hemoptysis followed by a massive oral hemorrhage. The patient suffered a cardiac arrest secondary to acute blood loss, from which he was successfully resuscitated.
  
  
  RESULTS
  An occlusion technique is presented involving direct carotid puncture for successful treatment of hemodynamically unstable, exsanguinating patients.
  
  
  CONCLUSIONS
  This technique accomplishes rapid arrest of exsanguination, minimal hemorrhage site manipulation, and successful carotid occlusion.
authors.affiliation: Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine at Peoria, Peoria, IL 61656, USA.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fraser
authors.forename: Carlo
authors.initials: C
authors.lastname: Bortolotti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lanzino
mesh_terms: D021721:Balloon Occlusion / Q000379:methods*; D002340:Carotid Artery Diseases / Q000628:therapy*; D004636:Emergency Service, Hospital; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D012422:Rupture, Spontaneous; D013577:Syndrome