ArticleJournal of the Chinese Medical Association : JCMA2022
Risk factors of recurrent carotid blowout syndrome and strategy of endovascular management.
Article in Journal of the Chinese Medical Association : JCMA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Prognosis of patients with carotid blowout syndrome in the era of endovascular interventions.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2025Article
- Interventional Treatment Strategies for Carotid Blowout Syndrome After Radiotherapy for Nasopharyngeal Carcinoma.Cancer management and research · 2025Article
- Winners of the 2022 honor awards for excellence at the annual meeting of the Chinese Medical Association-Taipei: Part II.Journal of the Chinese Medical Association : JCMA · 2023Article
- Winners of the 2022 honor awards for excellence at the annual meeting of the Chinese Medical Association-Taipei: Part I.Journal of the Chinese Medical Association : JCMA · 2023Article
- Management of double carotid blowout with definitive repair after temporizing stent graft placement.Journal of vascular surgery cases and innovative techniques · 2022Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCarotid blowout syndrome (CBS) is a catastrophic complication after aggressive head and neck cancer treatment. Endovascular embolization is an effective modality to manage CBS. However, some CBS may have recurrent CBS (rCBS) after endovascular management. This study aims to report the potential rCBS risk and endovascular management strategy.
methodsOf the 225 patients with CBS referred for embolization in 13 years, 31 men and one woman (mean age, 55 years) with 35 rCBS with pseudoaneurysms formation were identified after endovascular management. Moreover, the rCBS preembolization angioarchitecture, rCBS cause, rCBS time interval, embolic materials selection, and final embolization clinical/angiographic outcomes were retrospectively analyzed.
resultsrCBS with pseudoaneurysm due to disease progression (DP) occurred in 17 patients, while 15 patients had insufficient embolization (IE) with 18 rCBS. The mean rCBS timing interval was 76 days with 129 and 12 days due to DP or IE. The most common rCBS locations were the carotid bulb and the main trunk of the external carotid artery (n = 20, 57%), followed by internal carotid artery (n = 8, 23%), distal branch of the external carotid artery (n = 4, 11%), and common carotid artery (n = 3, 9%). Endovascular management was technically successful in all patients by reconstruction (n = 7, 20%) or destruction (n = 28, 80%) techniques. Three patients (9%) had procedure-related complications. No rCBS was observed in all affected arteries after the last embolization in a mean 11-month clinical follow-up.
conclusionrCBS may result from DP or IE. The common location of IE-related rCBS usually occurred in the carotid branches. It occurred within two weeks of CBS largely because of the underestimation of the extension of the affected carotid artery. In addition, DP is natural in head and neck cancer after aggressive treatment. Thus, endovascular management remained an effective method to manage rCBS.
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