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AJNR - American Journal of Neuroradiology

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Placement of Covered Stents for Carotid Blowout in Patients with Head and Neck Cancer: Follow-up Results after Rescue Treatments

H.W. Pyun^a, D.H. Lee^a, H.M. Yoo^a, J.H. Lee^a, C.G. Choi^a, S.J. Kim^a and D.C. Suh^a

^a From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

View larger version (68K): [in this window] [in a new window]   Fig 1. A 50-year-old man with nasopharyngeal cancer presents initially with massive oral bleeding. A, B, A large, lobulated pseudoaneurysm in the right carotid bulb is successfully isolated with use of detachable coils and a bare stent combined with a covered stent. C, D, Recurrent CB develops at the proximal end of the stent (arrow in C); a supplementary covered stent is inserted to obtain control of rebleeding. E, F, Permanent arterial occlusion is performed because of persistent bloody sputum 3 weeks after the second endovascular treatment.

View larger version (43K): [in this window] [in a new window]   Fig 2. A 69-year-old man with a small, blisterlike lesion of the right common carotid artery, detected incidentally during surgical reconstruction of his wound. A, Conventional angiography shows a small ulcerative lesion (arrow) in the distal portion of the right common carotid artery. B, The lesion disappeared after preventive placement of the covered stent. C, A massive contrast extravasation is noted, near the distal end of the previous inserted stent, on the right common carotid angiogram obtained for the evaluation of the rebleeding, which occurred 3 weeks after the initial procedure. D, Complete control of hemorrhage is achieved by additional insertion of a covered stent.