ENDOVASCULAR MANAGEMENT OF LIFE-THREATENING CAROTID BLOWOUT SYNDROME AFTER OSTEORADIONECROSIS OF THE MANDIBULA — A CASE REPORT AND LITERATURE REVIEW

Detalhes bibliográficos
Autor(a) principal: Coelho, Andreia
Data de Publicação: 2018
Outros Autores: Lobo, Miguel, Coelho, Gustavo, Azevedo, Marta, Campos, Jacinta, Augusto, Rita, Coelho, Nuno, Semião, Ana Carolina, Ribeiro, João Pedro, Costa, Horácio, Canedo, Alexandra
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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spelling 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
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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
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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