title: Multimodal endovascular palliation for femoral arterial blowout in the setting of metastatic vulvar carcinoma.
abstract: BACKGROUND
  Vascular blowout syndrome is a well-known, life-threatening condition complicating advanced-stage head and neck malignancies but has rarely been reported in the gynecologic oncology realm in association with the femoral circulation. A 50-year-old woman with metastatic vulvar squamous cell carcinoma presented with left threatened femoral arterial blowout, secondary to an exophytic neoplastic mass originating from the left inguinal lymph nodes.
  
  
  METHODS
  Bland embolization of the tumor as well as 3 vessel covered stent revascularization was successfully performed with excellent tumor devascularization and reinstitution of arterial integrity.
  
  
  RESULTS
  Successful devascularization of the tumor, with no non-target embolization was achieved, with excellent apposition and deployment of 3 covered stents in the femoral artery bifurcation.
  
  
  CONCLUSIONS
  We present a unique case of threatened femoral artery blowout syndrome in the setting of metastatic vulvar carcinoma requiring various endovascular techniques for palliation. These endovascular techniques can be invaluable in minimally invasive palliation of advanced stage neoplasms abutting the iliofemoral circulation.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ. Electronic address: naiem.nassiri@rutgers.edu.
authors.forename: Naiem
authors.initials: N
authors.lastname: Nassiri
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kogan
authors.affiliation: Department of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
authors.forename: Darlene G
authors.initials: DG
authors.lastname: Gibbon
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.
authors.forename: Alan
authors.initials: A
authors.lastname: Graham
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012422:Rupture, Spontaneous; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000473:pathology*