ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.146 |
Resumo: | Aim: Carotid blowout syndrome is a rare but devastating complication of head and neck malignancy, and is associated with a reported mortality and neurologic morbidity of 40% and 60% respectively. The aim of this case report is to present our experience with a single case of massive haemorrhage from the internal carotid artery (ICA) in a previously irradiated neck treated with a stentgraft, hence maintaining carotid artery patency. Methods: Relevant medical data were collected and literature review was performed. Results: The patient is a 61-year-old male with a previous history of head and neck cancer submitted to radical surgery and chemo and radiotherapy. Seven years later, the patient was diagnosed with osteoradionecrosis of the mandibula and submitted to surgery. Hospital stay was prolonged due to local infection and suture dehiscence with carotid artery exposure. No previous episodes of sentinel bleeding were registered. Life-threatening haemorrhage from the surgical wound started acutely. Under manual compression, the patient was rushed to the angiography suite and the diagnostic angiography ascertained active bleeding from the ICA. A stentgraft Atrium Advanta V12 (Maquet Getinge group, Hudson, NH, USA) was deployed maintaining ICA patency. The patient was subsequently submitted to surgical reconstruction and had an uneventful recovery. Discussion: Management of acute carotid blow syndrome is critical, often requiring a multidisciplinary approach. Stentgraft placement is a highly feasible and effective approach with lower morbimortality rates when compared to surgical repair/ ligation or endovascular embolization. However long term results with patency rates are currently lacking. |
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ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEWTRATAMENTO ENDOVASCULAR DE SÍNDROME DE CAROTID BLOWOUT AGUDO APÓS OSTEORADIONECROSE DA MANDÍBULA — A PROPÓSITO DE UM CASO CLÍNICOCarotid Blowout SindromeEndovascular ProceduresCarotid Artery InjuriesSindrome de Carotid BlowoutTratamento endovascularLesão da artéria carótidaAim: Carotid blowout syndrome is a rare but devastating complication of head and neck malignancy, and is associated with a reported mortality and neurologic morbidity of 40% and 60% respectively. The aim of this case report is to present our experience with a single case of massive haemorrhage from the internal carotid artery (ICA) in a previously irradiated neck treated with a stentgraft, hence maintaining carotid artery patency. Methods: Relevant medical data were collected and literature review was performed. Results: The patient is a 61-year-old male with a previous history of head and neck cancer submitted to radical surgery and chemo and radiotherapy. Seven years later, the patient was diagnosed with osteoradionecrosis of the mandibula and submitted to surgery. Hospital stay was prolonged due to local infection and suture dehiscence with carotid artery exposure. No previous episodes of sentinel bleeding were registered. Life-threatening haemorrhage from the surgical wound started acutely. Under manual compression, the patient was rushed to the angiography suite and the diagnostic angiography ascertained active bleeding from the ICA. A stentgraft Atrium Advanta V12 (Maquet Getinge group, Hudson, NH, USA) was deployed maintaining ICA patency. The patient was subsequently submitted to surgical reconstruction and had an uneventful recovery. Discussion: Management of acute carotid blow syndrome is critical, often requiring a multidisciplinary approach. Stentgraft placement is a highly feasible and effective approach with lower morbimortality rates when compared to surgical repair/ ligation or endovascular embolization. However long term results with patency rates are currently lacking.Objetivo: A síndrome de blowout carotídeo é uma complicação rara mas potencialmente catastrófica, da neoplasia de cabeça e pescoço, e está associada a uma mortalidade e morbidade neurológica reportadas de 40% e 60%, respetivamente. Pretende-se apresentar a nossa experiência com um caso de blowout carotídeo com hemorragia maciça com origem na artéria carótida interna (ACI) num doente com história prévia de radioterapia cervical e osteorradionecrose da mandíbula, tratado por via endovascular com colocação de um stent recoberto mantendo, assim, a permeabilidade carotídea. Métodos: Realizou-se revisão dos dados clínicos relevantes bem como revisão da literatura existente. Resultados: Trata-se de um doente do sexo masculino de 61 anos, com história prévia de neoplasia da cabeça e pescoço, submetido a cirurgia radical e quimio e radioterapia. Sete anos depois, o paciente foi diagnosticado com osteorradionecrose da mandíbula e submetido a cirurgia reconstrutiva. A estadia hospitalar pós-operatória foi prolongada por infeção local e deiscência da ferida cirúrgica com exposição carotídea. Não houve registo de episódios prévios de hemorragia sentinela, no entanto o doente apresentou inicio súbito de hemorragia major com origem na ferida cirúrgica. Sob compressão manual, o doente foi admitido na suite angiográfica tendo-se constatado hemorragia ativa da ACI. Posteriormente implantou-se um stent recoberto Atrium Advanta V12 (Maquet Getinge, Hudson, NH, EUA) mantendo-se a permeabilidade da ACI. Numa segunda fase, após estabilização do doente em unidade de cuidados intensivos, o doente foi submetido a reconstrução cirúrgica, sem intercorrências. Discussão: O tratamento da síndrome de blowout carotídeo agudo é emergente, exigindo muitas vezes uma abordagem multidisciplinar. A colocação de um stent recoberto é uma abordagem exequível e eficaz em contexto agudo, com menores taxas de morbimortalidade associadas, quando comparado ao tratamento/laqueação cirúrgica ou embolização endovascular. No entanto, desconhece-se os resultados a longo prazo, em particular taxas de permeabilidade.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2018-12-22T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.146oai:ojs.acvjournal.com:article/146Angiologia e Cirurgia Vascular; Vol. 14 No. 3 (2018): September; 212-215Angiologia e Cirurgia Vascular; Vol. 14 N.º 3 (2018): Setembro; 212-2152183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/146https://doi.org/10.48750/acv.146http://acvjournal.com/index.php/acv/article/view/146/111Copyright (c) 2018 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessCoelho, AndreiaLobo, MiguelCoelho, GustavoAzevedo, MartaCampos, JacintaAugusto, RitaCoelho, NunoSemião, Ana CarolinaRibeiro, João PedroCosta, HorácioCanedo, Alexandra2022-05-23T15:10:03Zoai:ojs.acvjournal.com:article/146Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:32.531096Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW TRATAMENTO ENDOVASCULAR DE SÍNDROME DE CAROTID BLOWOUT AGUDO APÓS OSTEORADIONECROSE DA MANDÍBULA — A PROPÓSITO DE UM CASO CLÍNICO |
title |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW |
spellingShingle |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW Coelho, Andreia Carotid Blowout Sindrome Endovascular Procedures Carotid Artery Injuries Sindrome de Carotid Blowout Tratamento endovascular Lesão da artéria carótida |
title_short |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW |
title_full |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW |
title_fullStr |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW |
title_full_unstemmed |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW |
title_sort |
ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW |
author |
Coelho, Andreia |
author_facet |
Coelho, Andreia Lobo, Miguel Coelho, Gustavo Azevedo, Marta Campos, Jacinta Augusto, Rita Coelho, Nuno Semião, Ana Carolina Ribeiro, João Pedro Costa, Horácio Canedo, Alexandra |
author_role |
author |
author2 |
Lobo, Miguel Coelho, Gustavo Azevedo, Marta Campos, Jacinta Augusto, Rita Coelho, Nuno Semião, Ana Carolina Ribeiro, João Pedro Costa, Horácio Canedo, Alexandra |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Coelho, Andreia Lobo, Miguel Coelho, Gustavo Azevedo, Marta Campos, Jacinta Augusto, Rita Coelho, Nuno Semião, Ana Carolina Ribeiro, João Pedro Costa, Horácio Canedo, Alexandra |
dc.subject.por.fl_str_mv |
Carotid Blowout Sindrome Endovascular Procedures Carotid Artery Injuries Sindrome de Carotid Blowout Tratamento endovascular Lesão da artéria carótida |
topic |
Carotid Blowout Sindrome Endovascular Procedures Carotid Artery Injuries Sindrome de Carotid Blowout Tratamento endovascular Lesão da artéria carótida |
description |
Aim: Carotid blowout syndrome is a rare but devastating complication of head and neck malignancy, and is associated with a reported mortality and neurologic morbidity of 40% and 60% respectively. The aim of this case report is to present our experience with a single case of massive haemorrhage from the internal carotid artery (ICA) in a previously irradiated neck treated with a stentgraft, hence maintaining carotid artery patency. Methods: Relevant medical data were collected and literature review was performed. Results: The patient is a 61-year-old male with a previous history of head and neck cancer submitted to radical surgery and chemo and radiotherapy. Seven years later, the patient was diagnosed with osteoradionecrosis of the mandibula and submitted to surgery. Hospital stay was prolonged due to local infection and suture dehiscence with carotid artery exposure. No previous episodes of sentinel bleeding were registered. Life-threatening haemorrhage from the surgical wound started acutely. Under manual compression, the patient was rushed to the angiography suite and the diagnostic angiography ascertained active bleeding from the ICA. A stentgraft Atrium Advanta V12 (Maquet Getinge group, Hudson, NH, USA) was deployed maintaining ICA patency. The patient was subsequently submitted to surgical reconstruction and had an uneventful recovery. Discussion: Management of acute carotid blow syndrome is critical, often requiring a multidisciplinary approach. Stentgraft placement is a highly feasible and effective approach with lower morbimortality rates when compared to surgical repair/ ligation or endovascular embolization. However long term results with patency rates are currently lacking. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-12-22T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.146 oai:ojs.acvjournal.com:article/146 |
url |
https://doi.org/10.48750/acv.146 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/146 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/146 https://doi.org/10.48750/acv.146 http://acvjournal.com/index.php/acv/article/view/146/111 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 14 No. 3 (2018): September; 212-215 Angiologia e Cirurgia Vascular; Vol. 14 N.º 3 (2018): Setembro; 212-215 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799129848836259840 |