Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Nov 13:10:5617-5628.
doi: 10.2147/CMAR.S180164. eCollection 2018.

Carotid blowout syndrome: modern trends in management

Carlos Suárez  1   2 , Verónica Fernández-Alvarez  3 , Marc Hamoir  4 , William M Mendenhall  5 , Primoz Strojan  6 , Miquel Quer  7 , Carl E Silver  8 , Juan P Rodrigo  1   2   9 , Alessandra Rinaldo  10 , Alfio Ferlito  11
Affiliations
Review

Carotid blowout syndrome: modern trends in management

Carlos Suárez et al. Cancer Manag Res. .

Abstract

Carotid blowout syndrome (CBS) refers to rupture of the carotid artery and is an uncommon complication of head and neck cancer that can be rapidly fatal without prompt diagnosis and intervention. CBS develops when a damaged arterial wall cannot sustain its integrity against the patient's blood pressure, mainly in patients who have undergone surgical procedures and radiotherapy due to cancer of the head and neck, or have been reirradiated for a recurrent or second primary tumor in the neck. Among patients irradiated prior to surgery, CBS is usually a result of wound breakdown, pharyngocutaneous fistula and infection. This complication has often been fatal in the past, but at the present time, early diagnosis and modern technology applied to its management have decreased morbidity and mortality rates. In addition to analysis of the causes and consequences of CBS, the purpose of this paper is to critically review methods for early diagnosis of this complication and establish individualized treatment based on endovascular procedures for each patient.

Keywords: carotid blowout; covered stents; embolization; head and neck cancer; reirradiation; surgery.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Management algorithm for CBS. Abbreviations: CBS, carotid blowout syndrome; CCA, common carotid artery; ECA, external carotid artery; ICA, internal carotid artery; CTA, computed tomographic angiography; CVA, cerebrovascular accident; IR, interventional radiology.
See this image and copyright information in PMC

References

    1. Chang FC, Lirng JF, Luo CB, et al. Patients with head and neck cancers and associated postirradiated carotid blowout syndrome: endovascular therapeutic methods and outcomes. J Vasc Surg. 2008;47(5):936–945. - PubMed
    1. Leikensohn J, Milko D, Cotton R. Carotid artery rupture. Management and prevention of delayed neurologic sequelae with low-dose heparin. Arch Otolaryngol. 1978;104(6):307–310. - PubMed
    1. Shumrick DA. Carotid artery rupture. Laryngoscope. 1973;83(7):1051–1061. - PubMed
    1. Martinez SA, Oller DW, Gee W, de Fries HO. Elective carotid artery resection. Arch Otolaryngol. 1975;101(12):744–747. - PubMed
    1. Ketcham AS, Hoye RC. Spontaneous carotid artery hemorrhage after head and neck surgery. Am J Surg. 1965;110(4):649–655. - PubMed