Summary of patients with carotid blowout syndrome treated with self-expandable stent-grafts

Patient No./Age (y)/SexCancer and Treatment HistoryPresentationBlowoutStent-Graft (mm)*Initial ComplicationFollow-UpOutcome
Onset (y)GroupLocation
1/35/MMixed, submandibular gland; wide excision, R/T, C/TRecurrence, RN; lung, kidney metastasis5AcuteCBF8 × 50Asymptomatic acute ICA thrombosis and occlusionNot applicable19 d: rebleed; died
2/43/MTonsillar; wide excision, R/T, C/TRecurrence, RN1AcuteCCA8 × 30NoneNot applicable2 d: rebleed; died
3/52/MLaryngeal; total laryngectomy, R/T, C/TRecurrence, RN, PCF4AcuteICA7 × 30, 9 × 50Asymptomatic transient in-stent thrombosisRebleed wk 3, second stent-graft; patency on 1-mo CTA & 3-mo angiogram6-mo CT: asymptomatic carotid thrombosis; lived 20 mo
4/49/MNasopharyngeal, R/T; second primary hypopharyngeal, R/T, C/TRecurrent hypopharyngeal cancer, RN12, 1ImpendingCBF8 × 50Embolic infarct, MCA territoryStent patency on 1-mo CT, sonography2-mo: died from progression
5/52/MHypopharyngeal; R/T, C/TSlightly swollen soft tissue of neck1ImpendingCBF8 × 50NoneStent patency on 2-mo CTA4-mo: septic carotid thrombosis, brain, abscess; lived 14 mo
6/65/MLaryngeal; R/TRN, PCF4AcuteCCA, CBF8 × 50, 8 × 50NoneRebleed at 2-mo, second stent-graft; rebleed at 3-mo, direct percutaneous ECA puncture for embolization; stent patency at 3-mo CT5-mo CT: asymptomatic carotid thrombosis; lived 13 mo
7/44/MHypopharyngeal; total laryngopharyngectomy, C/T, R/TRecurrence, RN, PCF, lung metastasis1/2ThreatenedCCA9 × 70NoneStent patency on 2-wk sonography1-mo: died from lung metastasis
8/54/MLower esophageal, primary hypopharyngeal; esophagectomy, laryngectomy, C/T, R/TRecurrence, RN, PCF1ThreatenedCCA9 × 70NoneStent patency on 2-wk CTA1.5-mo: died from progression, mediastinitis
  • Note.—CBF indicates carotid bifurcation; CCA, common carotid artery; C/T, chemotherapy; CTA, CT angiography; ECA, external carotid artery; MCA, middle cerebral artery; PCF, pharyngocutaneous fistula; RN, radiation necrosis; R/T, radiotherapy.

  • * Wallgraft; Boston Scientific Corporation.

  • Immediate hemostasis was achieved in all patients.

  • Plus 3 fiber coils in the ECA