Safety and effectiveness of endovascular embolization or stent-graft reconstruction for treatment of acute carotid blowout syndrome in patients with head and neck cancer: Case series and systematic review of observational studies.

Autor: Wong DJY; Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Australia., Donaldson C; Department of Neurosurgery, Monash Health, Melbourne, Australia., Lai LT; Department of Neurosurgery, Monash Health, Melbourne, Australia., Coleman A; Peter MacCallum Cancer Institute, Melbourne, Australia., Giddings C; Department of Otolaryngology, Monash Health, Melbourne, Australia., Slater LA; School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia., Chandra RV; Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Australia.; School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2018 Apr; Vol. 40 (4), pp. 846-854. Date of Electronic Publication: 2017 Nov 20.
DOI: 10.1002/hed.25018
Abstrakt: Background: Indications for treatment and outcomes after endovascular management of carotid blowout syndrome for patients with head and neck cancer are not well defined. We investigated the safety and effectiveness of endovascular embolization and stent-graft reconstruction.
Methods: A literature review was performed for studies published between 2001 and 2015 with relevance to treatment outcomes. Our institutional database was examined to identify patients treated with endovascular techniques.
Results: A total of 266 patients were included. Rates of procedural stroke were higher after embolization of internal carotid artery (ICA)/common carotid artery (CCA) compared to stent graft (embolization 10.3%; stent graft 2.5%; P < .02). Stent graft of ICA/CCA was associated with higher rates of recurrent bleeding (embolization 9.1%; stent graft 31.9%; P < .01).
Conclusion: Both embolization and stent grafts are safe therapeutic options for acute carotid blowout syndrome. Embolization for ICA/CCA carotid blowout syndrome was associated with higher risks of procedural stroke and lower recurrent bleeding compared to stent grafts.
(© 2017 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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