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: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010
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 reviewCarotid Blowout SindromeEndovascular ProceduresCarotid Artery InjuriesAim: 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.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2018-09-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010Angiologia e Cirurgia Vascular v.14 n.3 2018reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010Coelho,AndreiaLobo,MiguelCoelho,GustavoAzevedo,MartaCampos,JacintaAugusto,RitaCoelho,NunoSemião,Ana CarolinaRibeiro,João PedroCosta,HorácioCanedo,Alexandrainfo:eu-repo/semantics/openAccess2024-02-06T17:22:52Zoai:scielo:S1646-706X2018000300010Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:29:23.392412Repositório 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
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
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
topic Carotid Blowout Sindrome
Endovascular Procedures
Carotid Artery Injuries
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 2018-09-01
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dc.identifier.uri.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
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 v.14 n.3 2018
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str 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)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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