title: Covered stent graft for treatment of a pseudoaneurysm and carotid blowout syndrome.
abstract: BACKGROUND
  Carotid blowout syndrome with pseudoaneurysm, a rapidly progressive pathology, may present emergently with massive oral hemorrhage. Use of an endograft prosthesis offers a treatment strategy with salvation of the carotid artery.
  
  
  METHODS
  A 55 year old man with advanced squamous cell carcinoma of the head and neck presented with recurrent transoral hemorrhage, requiring endovascular treatment.
  Coil embolization was initially performed with little impact on the hemorrhage. A 7 x 40 mm Fluency® Plus covered stent (Bard Peripheral Vascular, Tempe, Arizona, USA) was placed and was supplemented by a second 8 x 40 mm Fluency Plus stent, with resulting cessation of active contrast extravasation.
  
  
  CONCLUSIONS
  The risks and benefits of various treatment options of carotid pseudoaneurysm with blowout are discussed including the use or omission of antiplatelet and anticoagulant regimens, with reference to previously reported cases.
  
  
  CONCLUSIONS
  Tandem, overlapping covered stent placement in the common carotid artery is feasible and offers a treatment option for carotid blowout syndrome. Risks of aggravation of hemorrhage versus long-term thromboembolic events without antiplatelet therapy must be considered in cases of active ongoing hemorrhage.
authors.affiliation: Zeenat Qureshi Stroke Research Center, Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey.
authors.forename: Nazli
authors.initials: N
authors.lastname: Janjua
authors.forename: Ammar
authors.initials: A
authors.lastname: Alkawi
authors.forename: Alexandros L
authors.initials: AL
authors.lastname: Georgiadis
authors.forename: Jawad F
authors.initials: JF
authors.lastname: Kirmani
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi