Radiation carotid blowout syndrome in nasopharyngeal carcinoma: angiographic features and endovascular management.
OBJECTIVE
To report clinical manifestations, angiographic features, and outcomes of endovascular management in 14 patients with 15 radiation carotid blowout syndromes of nasopharyngeal carcinomas.


METHODS
Retrospective chart review of 14 patients with nasopharyngeal carcinomas (mean age 49 years) with 15 radiation carotid blowout syndromes who had undergone endovascular embolization to manage oronasal bleeding in the past 10 years.


RESULTS
Average radiation dose to affected carotid artery was 73 gray units (latent period: 33 months). Radiation carotid blowout syndrome was detected in internal (n = 10), external (n = 4), or common carotid artery (n = 1). Detachable balloons were used in 11 affecting arteries for vascular occlusion; 4 were treated by liquid adhesives or coil. Endovascular treatment was successful in all 15 radiation carotid blowout syndromes with cessation of hemorrhage. One patient had hemiparesis after embolization. Mean clinical follow-up was 21 months.


CONCLUSIONS
Radiation carotid blowout syndrome in nasopharyngeal carcinoma may occur in various periods or arteries. Endovascular embolization provides both safe and effective management.
Luo
Chao-Bao
CB
Department of Radiology, Taipei Veterans General Hospital, Tapei, Taiwan, ROC. cbluo@vghtpe.gov.tw
Teng
Michael Mu-Huo
MM
Chang
Feng-Chi
FC
Chang
Cheng-Yen
CY
Guo
Wan-You
WY
D000328:Adult; D000792:Angiography / Q000379:methods*; D017546:Angioscopy / Q000379:methods*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000528:radiation effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D006472:Oral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011832:Radiation Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D016896:Treatment Outcome