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Endovascular management of life-threatening carotid blowout syndrome after osteoradionecrosis of the mandibula: a case report and literature review

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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.
Autores principais:Coelho,Andreia
Outros Autores:Lobo,Miguel; Coelho,Gustavo; Azevedo,Marta; Campos,Jacinta; Augusto,Rita; Coelho,Nuno; Semião,Ana Carolina; Ribeiro,João Pedro; Costa,Horácio; Canedo,Alexandra
Assunto:Carotid Blowout Sindrome Endovascular Procedures Carotid Artery Injuries
Ano:2018
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Coelho,Andreia
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
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
country_str PT
creators_json_txt [{\"Person.name\":\"Coelho,Andreia\"},{\"Person.name\":\"Lobo,Miguel\"},{\"Person.name\":\"Coelho,Gustavo\"},{\"Person.name\":\"Azevedo,Marta\"},{\"Person.name\":\"Campos,Jacinta\"},{\"Person.name\":\"Augusto,Rita\"},{\"Person.name\":\"Coelho,Nuno\"},{\"Person.name\":\"Semião,Ana Carolina\"},{\"Person.name\":\"Ribeiro,João Pedro\"},{\"Person.name\":\"Costa,Horácio\"},{\"Person.name\":\"Canedo,Alexandra\"}]
datacite.creators.creator.creatorName.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
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Carotid Blowout Sindrome
Endovascular Procedures
Carotid Artery Injuries
datacite.titles.title.fl_str_mv Endovascular management of life-threatening carotid blowout syndrome after osteoradionecrosis of the mandibula: a case report and literature review
dc.creator.none.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.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Angiologia e Cirurgia Vascular
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Angiologia e Cirurgia Vascular v.14 n.3 2018
dc.subject.none.fl_str_mv Carotid Blowout Sindrome
Endovascular Procedures
Carotid Artery Injuries
dc.title.fl_str_mv Endovascular management of life-threatening carotid blowout syndrome after osteoradionecrosis of the mandibula: a case report and literature review
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_93fc
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.
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person_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
publishDate 2018
publisher.none.fl_str_mv Sociedade Portuguesa de Angiologia e Cirurgia Vascular
reponame_str SciELO Portugal
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spelling Endovascular management of life-threatening carotid blowout syndrome after osteoradionecrosis of the mandibula: a case report and literature reviewCoelho,AndreiaLobo,MiguelCoelho,GustavoAzevedo,MartaCampos,JacintaAugusto,RitaCoelho,NunoSemião,Ana CarolinaRibeiro,João PedroCosta,HorácioCanedo,AlexandraCarotid Blowout SindromeEndovascular ProceduresCarotid Artery Injuriesopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010URLHasVersion2018-09-01Aim: 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 VascularAngiologia e Cirurgia Vascular v.14 n.3 2018text/htmlengreporthttp://purl.org/coar/resource_type/c_93fcother research product
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
status SINGLETON
subject.fl_str_mv Carotid Blowout Sindrome
Endovascular Procedures
Carotid Artery Injuries
title 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_short 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
topic Carotid Blowout Sindrome
Endovascular Procedures
Carotid Artery Injuries
topic_facet Carotid Blowout Sindrome
Endovascular Procedures
Carotid Artery Injuries
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2018000300010
visible 1