Endovascular carotid reconstruction in palliative head and neck cancer patients with threatened carotid blowout presents a beneficial supportive care measure.
ABSTRACT Carotid blowout is a devastating complication in patients with head and neck malignancy. The traditional surgical treatment for carotid blowout is often technically difficult and is associated with an unacceptably high morbidity and mortality. Recently, endovascular therapy has been proposed for head and neck surgical patients. Preliminary reports showed a better outcome with less morbidity and mortality compared to the previous treatment modalities. The use of such techniques in cases of impending or acute carotid blowout syndrome has been previously described to be beneficial for palliative head and neck cancer patients as well. We introduce a case of a head and neck cancer patient receiving palliative care, presenting with threatened carotid blowout, who was managed with endovascular placement of a covered stent under elective conditions in order to prevent an inevitable carotid rupture. In the present case endovascular carotid stenting allowed preservation of the vessel, prevented the dramatic situation of carotid rupture, and facilitated a rapid hospital discharge without any neurologic or stenting sequelae.
Koutsimpelas
Dimitrios
D
Department of Otorhinolaryngology, University Hospital of Mainz, Mainz, Germany. koutsimpelas@hno.klinik.uni-mainz.de
Pitton
Michael
M
Külkens
Christoph
C
Lippert
Burkard M
BM
Mann
Wolf J
WJ
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002340:Carotid Artery Diseases / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D010166:Palliative Care; D012422:Rupture, Spontaneous; D015607:Stents