title: Follow-up for covered stent treatment of carotid blow-out syndrome in patients with head and neck cancer.
abstract: OBJECTIVE
  Carotid blow-out syndrome (CBS) is a life-threatening complication of head and neck cancer (HNC). One of the various methods used for emergency management of CBS is covered stent placement (CSP). Our initial experience in CSP is evaluated and compared with reports in the literature.
  
  
  METHODS
  This study analysed 17 patients with HNC who had received CSP for CBS at Kaohsiung Medical University Chung-Ho Memorial Hospital from May 2005 to December 2013. The medical records and images for these patients were retrospectively reviewed to evaluate the causes of CBS, treatment success rates and complications.
  
  
  RESULTS
  The initial angiography success rate was 100%. Procedural or periprocedural complications were noted in two (12%) cases, both suffering from cerebral vascular accident (CVA). Short-term complications were noted in eight (47%) cases, including four rebleeding cases and four CVA cases. Medium- to long-term complications were noted in nine cases, which included two asymptomatic in-stent thrombosis cases, one symptomatic CVA case, two abscess formation cases and four rebleeding cases. Overall, eight (47%) cases of rebleeding occurred during follow-up. Three of the eight cases were fatal, accounting for 27% of the all-cause mortality.
  
  
  CONCLUSIONS
  Although CSP is considered effective for achieving haemostasis in patients with HNC with CBS, the medium- to long-term outcomes are unfavourable owing to high risks of rebleeding, CVA and other complications. Therefore, CSP should be considered a temporary life-saving technique rather than a definitive treatment.
  
  
  CONCLUSIONS
  Analysis of the relatively large series of patients with HNC in this study suggests that CSP is a useful temporary treatment for CBS.
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Wu
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Lin
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|2 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Jui-Sheng
authors.initials: JS
authors.lastname: Hsu
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: I-Ting
authors.initials: IT
authors.lastname: Han
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Tsyh-Jyi
authors.initials: TJ
authors.lastname: Hsieh
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Gin-Chung
authors.initials: GC
authors.lastname: Liu
authors.affiliation: 1 Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Chiang
mesh_terms: D000328:Adult; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D002533:Cerebral Angiography; D003287:Contrast Media; D004630:Emergencies; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media