ArticleNeurosurgical review2025
Clinical analysis of intracranial and extracranial vascular bypass surgery for carotid blowout syndrome in nasopharyngeal carcinoma.
Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Preventing Carotid Blowout: Planned Carotid Sacrifice and Cerebral Revascularization Enabling Second Reirradiation in Recurrent Nasopharyngeal Carcinoma.Advances in radiation oncology · 2026Article
- A case of carotid blowout syndrome following endoscopic endonasal surgery and proton beam therapy for chondrosarcoma: Considering the role of nasoseptal mucosal flap for minimizing bleeding.Surgical neurology international · 2026Article
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Authors and funding
6 authors.
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Abstract
This study aimed to evaluate the clinical efficacy of intracranial and extracranial vascular bypass surgery for patients with nasopharyngeal carcinoma (NPC) with internal carotid artery invasion after radiotherapy. Sixty-five patients with internal carotid artery blowout syndrome admitted to our center between May 2018 and June 2020 were retrospectively analyzed, including 48 males and 17 females, The patients were divided into two groups: (an intracranial and extracranial vascular bypass group and an internal carotid artery embolization group)and followed up for 1-23 months. We compared the incidence of stroke events and the mortality rate between the two patient groups. In the intracranial and extracranial vascular bypass group, four patients (4/22, 18.2%) died postoperatively due to bleeding and pulmonary infection. Additionally, three patients (3/22, 13.6%) developed new-onset neurological disorders during follow-up, with two of them experiencing right limb hemiplegic paralysis. In the internal carotid artery (ICA) embolization group, six patients (6/43, 13.9%) died within 3-5 months postoperatively due to epistaxis, cerebral hemorrhage, and infectious pneumonia. Furthermore, 16 patients (16/43, 37.2%) developed new-onset neurological disorders during follow-up, with one of them experiencing hemiparesis. Statistical analyses revealed a significant difference in the incidence of new-onset neurological function abnormalities after treatment between the intracranial and extracranial vascular bypass group and the internal carotid artery embolization group (P = 0.039), indicating that bypass is more effective. Intracranial and extracranial vascular bypass surgery following internal carotid artery embolization produced better outcomes in patients with positive balloon test occlusion (BTO) results and reduced the incidence of ischemic events and new-onset neurological disorders after embolization.
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