Total amount: € 0,00
Official Journal of the Italian Society of Maxillofacial Surgery
Frequency: 3 issues
Online ISSN 1827-1901
Castellan L., Causin F., Perini S., Padula E. *
From the Institute of Neuroradiology
* Maxillo-Facial Surgery Department, “S. Bortolo” Hospital, Vicenza, Italy
The carotid rupture for neoplastic infiltration is a critical complication in patient with advanced malignant neoplasm of the neck. We describe different endovascular treatments and a potential role of the stents in patients with hemorrhage due to rupture of the carotid arteries for cervical cancer. Three cases were reviewed in order to study the etiologic factors of the carotid hemorrhages, the efficacy and the rationale of the different endovascular procedures and the outcomes. All the patients were previously treated for carcinoma of the neck. The causes of the hemorrhage were neoplastic infiltration of the carotid bifurcation, postradionecrosis pharyngocutaneous fistula and postoperative pseudo-aneurysm, respectively. After preliminary angiography, endovascular embolization with occlusion of the carotid bifurcation with balloons, coils and particles, delivery of covered balloon-expandable stent and of not covered self-expandable stents were performed, respectively. All the procedures were efficient with no complications and no re-bleedings during a mean follow-up of 24 months. Since the surgical carotid reconstruction for advanced cervical cancer has a high morbidity rate, the endovascular treatment is a safe therapeutic option in these patients. If allowed by the anatomical situation, the use of covered stents must be preferred.