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Title: CAROTID BLOWOUT SYNDROME: UNVEILING A RARE ONCOLOGICAL EMERGENCY
e-poster Number: EPOS 49
Category: e Poster
Author Name: Dr. Sunay G Duragappanavar
Institute:
Co-Author Name:
Abstract :
BACKGROUND/OBJECTIVES:
Carotid blowout syndrome(CBS)is the rupture of the carotid artery and its branches after treatment of advanced head and neck cancer. Despite its infrequency, CBS poses a significant challenge and potential for catastrophic hemorrhage, necessitating urgent recognition and intervention. CBS is associated with neurological morbidity and mortality above 60% and 40% respectively.
METHODS:
Case series of 3 post operative head and neck cancer patients who were referred to department of Intervention radiology, HCG Bangalore between 2013-2023 for endovascular management of carotid blow out syndrome diagnosed on CT carotid angiography. All 3 patients presented with bleeding episodes per oral or from soft tissues of neck. Two patients belonged to CBS Category II and one of CBS category III.
In all cases selective common and internal carotid artery angiogram was done to localize the Pseudoaneurysm/ extravasation site. Endovascular covered stents - 7X40mm COVERA PLUS was placed across the neck of pseudoaneurysm in case 1 & 3, a 7x60mm FLUENCY vascular covered stent was placed in case 2 across contrast extravsation site
RESULTS :
All patients were managed by endovascular covered stent placement across the neck of pseudoaneurysm/ bleeding points. Post stent deployment angiogram showed no contrast extravasation/ pseudoaneurysm in adjacent soft tissue in all 3 patients. One patient required post stenting balloon angioplasty. All 3 patients had no neurological deficit /further episodes of bleeding upto 3 months of follow up.
CONCLUSION :
Carotid Blowout Syndrome is a rare yet critical sequelae of head and neck cancer management . Endovascular covered stent placement / coil embolization is a safe minimally invasive treatment option in high risk post-surgical patients .
