Rare Presentation of Carotid Artery Stent Expulsion via Oropharyngeal Fistula in a Patient With Advanced Head and Neck Cancer-Case Study

Abstract

PurposeThis case report aims to describe the rare and severe complication of carotid artery stent expulsion via an oropharyngeal fistula (OCF) in a 59-year-old male with head and neck cancer. The study emphasizes the unique interplay between oropharyngeal cancer and carotid artery blowout and highlights a novel presentation of OCF in a patient with advanced comorbidities.CaseA 59-year-old male with oropharyngeal squamous cell carcinoma, carotid artery stenosis, and multiple comorbidities underwent chemotherapy, pseudoaneurysm embolization, and carotid artery stenting. Four months after carotid artery stent placement, the patient expelled the carotid stent through an oropharyngeal fistula. Imaging confirmed a chronic fistula and occlusion of the right carotid artery. Remarkably, the patient remained hemodynamically stable due to collateral circulation, allowing for safe discharge without further intervention.ConclusionsThis case illustrates an exceedingly rare presentation of carotid artery stent expulsion through an oropharyngeal fistula in a patient with severe carotid stenosis and head and neck cancer. This case underscores the importance of vigilance in patients with high-risk comorbidities undergoing vascular interventions for head and neck cancers. It also adds to the literature by highlighting a potential, albeit rare, complication of carotid stenting in the context of oropharyngeal malignancy.

Keywords: carotid artery blowout; carotid artery stenosis; carotid artery stent; head and neck cancer; oropharyngeal fistula; oropharyngeal squamous cell carcinoma; stent expulsion.