title: Endovascular Management of Patients with Head and Neck Cancers Presenting with Acute Hemorrhage: A Single-Center Retrospective Study.
abstract: OBJECTIVE
  Acute hemorrhage associated with cancers of the head and neck is a life-threatening condition that requires immediate action. The aim of this study was to assess the safety and efficacy of endovascular embolization for acute hemorrhage in patients with head and neck cancers.
  
  
  METHODS
  Data were retrospectively collected from patients with head and neck cancers who underwent endovascular embolization to treat acute hemorrhage. The primary endpoint was the rate of immediate control of hemorrhage during the first 24 h after embolization. The secondary endpoints were technical or clinical complications, rate of re-hemorrhage 24 h after the procedure, time from embolization to re-hemorrhage, hospitalization time, mortality rate, and time from embolization to death.
  
  
  RESULTS
  Fifty-one patients underwent endovascular embolization. The primary endpoint was achieved in 94% of patients. The rate of technical complications was 5.8%, and no clinical complication was observed. Twelve patients (23.5%) had hemorrhage recurrence after an average time of 127.5 days. The average hospitalization time was 7.4 days, the mortality rate during the follow-up period was 66.6%, and the average time from embolization to death was 132.5 days.
  
  
  CONCLUSIONS
  Endovascular embolization to treat acute hemorrhage in patients with head and neck cancers is a safe and effective method for the immediate control of hemorrhage and results in a high rate of hemorrhage control. Larger studies are necessary to determine which treatment strategy is best for improving patient outcomes.
authors.affiliation: Division of Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil.
authors.forename: P P
authors.initials: PP
authors.lastname: Vilas Boas
authors.affiliation: Division of Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil.
authors.forename: L H
authors.initials: LH
authors.lastname: de Castro-Afonso
authors.affiliation: Division of Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil.
authors.forename: L M
authors.initials: LM
authors.lastname: Monsignore
authors.affiliation: Division of Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil.
authors.forename: G S
authors.initials: GS
authors.lastname: Nakiri
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: F V
authors.initials: FV
authors.lastname: de Mello-Filho
authors.affiliation: Division of Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil. dgabud@fmrp.usp.br.
authors.forename: D G
authors.initials: DG
authors.lastname: Abud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Acute hemorrhage; Embolization; Endovascular procedures; Head and neck cancers