Carotid Blowout Management in the Endovascular Era
Carotid blowout syndrome (CBS) is a potential complication of head and neck cancer, and its therapy is associated with high morbidity and mortality. Recent advances in endovascular techniques have improved patient outcomes. In this study, we report outcomes of emergent endovascular intervention for...
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| Veröffentlicht in: | World neurosurgery 2020-09, Vol.141, p.e1010-e1016 |
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| creator | Weinberg, Joshua H. Sweid, Ahmad Joffe, Daniel Piper, Keenan Abbas, Rawad Hussain, Zubin Anderson, Brigitte Gooch, Michael Reid Herial, Nabeel Tjoumakaris, Stavropoula Hasan, David Zarzour, Hekmat Rosenwasser, Robert H. Jabbour, Pascal |
| description | Carotid blowout syndrome (CBS) is a potential complication of head and neck cancer, and its therapy is associated with high morbidity and mortality. Recent advances in endovascular techniques have improved patient outcomes. In this study, we report outcomes of emergent endovascular intervention for CBS.
We conducted a retrospective analysis of a prospectively maintained neurovascular database and identified 38 consecutive endovascular procedures for CBS from 2008–2019 at our institution. Data collection was performed on patient demographics, type of cancer, previous cancer treatments, type of CBS, location of bleed, diagnostic workup, endovascular treatment, and procedural outcomes and complications.
A total of 38 consecutive endovascular procedures for CBS were performed from 2008–2019 at our single academic institution. Technical success was achieved in 100% of endovascular procedures. Procedural stroke occurred in 1 (2.6%) procedure, procedural mortality occurred in 1 (2.6%) procedure, recurrent CBS occurred in 4 (10.5%) procedures, and fatal rehemorrhage occurred in 1 (2.6%) procedure. Regarding secondary outcomes, delayed stroke/transient ischemic attack occurred in 1 (2.6%) procedure, whereas there were no cases of delayed infectious complications.
The endovascular treatment of CBS is safe and effective with relatively low rates of morbidity and mortality compared with other currently available treatment modalities. However, the overall rate of complications demands attention and sheds light on the need for further improvement in management. |
| doi_str_mv | 10.1016/j.wneu.2020.06.151 |
| format | Article |
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We conducted a retrospective analysis of a prospectively maintained neurovascular database and identified 38 consecutive endovascular procedures for CBS from 2008–2019 at our institution. Data collection was performed on patient demographics, type of cancer, previous cancer treatments, type of CBS, location of bleed, diagnostic workup, endovascular treatment, and procedural outcomes and complications.
A total of 38 consecutive endovascular procedures for CBS were performed from 2008–2019 at our single academic institution. Technical success was achieved in 100% of endovascular procedures. Procedural stroke occurred in 1 (2.6%) procedure, procedural mortality occurred in 1 (2.6%) procedure, recurrent CBS occurred in 4 (10.5%) procedures, and fatal rehemorrhage occurred in 1 (2.6%) procedure. Regarding secondary outcomes, delayed stroke/transient ischemic attack occurred in 1 (2.6%) procedure, whereas there were no cases of delayed infectious complications.
The endovascular treatment of CBS is safe and effective with relatively low rates of morbidity and mortality compared with other currently available treatment modalities. However, the overall rate of complications demands attention and sheds light on the need for further improvement in management.</description><identifier>ISSN: 1878-8750</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2020.06.151</identifier><identifier>PMID: 32599207</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Carotid Artery Diseases - epidemiology ; Carotid Artery Diseases - surgery ; Carotid blowout ; Clinical Neurology ; Covered stent ; Databases, Factual ; Deconstruction ; Disease Management ; Embolization ; Embolization, Therapeutic - adverse effects ; Embolization, Therapeutic - methods ; Endovascular ; Endovascular Procedures - adverse effects ; Endovascular Procedures - methods ; Female ; Humans ; Life Sciences & Biomedicine ; Male ; Middle Aged ; Neurosciences & Neurology ; Reconstruction ; Retrospective Studies ; Science & Technology ; Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>World neurosurgery, 2020-09, Vol.141, p.e1010-e1016</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>4</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000564383400040</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c356t-899cf461723c8b1c12f31797a2d952d31eb6fe3b8e9c05bb5661410e752d32ba3</citedby><cites>FETCH-LOGICAL-c356t-899cf461723c8b1c12f31797a2d952d31eb6fe3b8e9c05bb5661410e752d32ba3</cites><orcidid>0000-0002-8965-2413 ; 0000-0002-1054-9414 ; 0000-0002-3464-5697 ; 0000-0002-2652-2451 ; 0000-0002-7797-1935</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.wneu.2020.06.151$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,28257,46004</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32599207$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weinberg, Joshua H.</creatorcontrib><creatorcontrib>Sweid, Ahmad</creatorcontrib><creatorcontrib>Joffe, Daniel</creatorcontrib><creatorcontrib>Piper, Keenan</creatorcontrib><creatorcontrib>Abbas, Rawad</creatorcontrib><creatorcontrib>Hussain, Zubin</creatorcontrib><creatorcontrib>Anderson, Brigitte</creatorcontrib><creatorcontrib>Gooch, Michael Reid</creatorcontrib><creatorcontrib>Herial, Nabeel</creatorcontrib><creatorcontrib>Tjoumakaris, Stavropoula</creatorcontrib><creatorcontrib>Hasan, David</creatorcontrib><creatorcontrib>Zarzour, Hekmat</creatorcontrib><creatorcontrib>Rosenwasser, Robert H.</creatorcontrib><creatorcontrib>Jabbour, Pascal</creatorcontrib><title>Carotid Blowout Management in the Endovascular Era</title><title>World neurosurgery</title><addtitle>WORLD NEUROSURG</addtitle><addtitle>World Neurosurg</addtitle><description>Carotid blowout syndrome (CBS) is a potential complication of head and neck cancer, and its therapy is associated with high morbidity and mortality. Recent advances in endovascular techniques have improved patient outcomes. In this study, we report outcomes of emergent endovascular intervention for CBS.
We conducted a retrospective analysis of a prospectively maintained neurovascular database and identified 38 consecutive endovascular procedures for CBS from 2008–2019 at our institution. Data collection was performed on patient demographics, type of cancer, previous cancer treatments, type of CBS, location of bleed, diagnostic workup, endovascular treatment, and procedural outcomes and complications.
A total of 38 consecutive endovascular procedures for CBS were performed from 2008–2019 at our single academic institution. Technical success was achieved in 100% of endovascular procedures. Procedural stroke occurred in 1 (2.6%) procedure, procedural mortality occurred in 1 (2.6%) procedure, recurrent CBS occurred in 4 (10.5%) procedures, and fatal rehemorrhage occurred in 1 (2.6%) procedure. Regarding secondary outcomes, delayed stroke/transient ischemic attack occurred in 1 (2.6%) procedure, whereas there were no cases of delayed infectious complications.
The endovascular treatment of CBS is safe and effective with relatively low rates of morbidity and mortality compared with other currently available treatment modalities. However, the overall rate of complications demands attention and sheds light on the need for further improvement in management.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Carotid Artery Diseases - epidemiology</subject><subject>Carotid Artery Diseases - surgery</subject><subject>Carotid blowout</subject><subject>Clinical Neurology</subject><subject>Covered stent</subject><subject>Databases, Factual</subject><subject>Deconstruction</subject><subject>Disease Management</subject><subject>Embolization</subject><subject>Embolization, Therapeutic - adverse effects</subject><subject>Embolization, Therapeutic - methods</subject><subject>Endovascular</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurosciences & Neurology</subject><subject>Reconstruction</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1878-8750</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkMtqGzEUQEVIiUOSH8iizDJQPNVjRg_oph3cByR0k6yFRnMnlRlLrqSJyd9Xxo6XJdrogs65oIPQLcE1wYR_Xtc7D3NNMcU15jVpyRm6JFLIpRRcnZ_mFi_QTUprXA4jjRTsAi0YbZWiWFwi2pkYshuqb1PYhTlXD8abZ9iAz5XzVf4D1coP4cUkO08mVqtortGH0UwJbo73FXr6vnrsfi7vf__41X29X1rW8ryUStmx4URQZmVPLKEjI0IJQwfV0oER6PkIrJegLG77vuWcNASD2D_S3rArdHfYu43h7wwp641LFqbJeAhz0rQhCismhCooPaA2hpQijHob3cbEV02w3ufSa73Ppfe5NOa65CrSx-P-ud_AcFLe4hRAHoAd9GFM1oG3cMJKz5Y3TLKmTA3uXDbZBd-F2eeifnq_WugvBxpKzhcHUR-NwUWwWQ_B_e8j_wAJSZpY</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Weinberg, Joshua H.</creator><creator>Sweid, Ahmad</creator><creator>Joffe, Daniel</creator><creator>Piper, Keenan</creator><creator>Abbas, Rawad</creator><creator>Hussain, Zubin</creator><creator>Anderson, Brigitte</creator><creator>Gooch, Michael Reid</creator><creator>Herial, Nabeel</creator><creator>Tjoumakaris, Stavropoula</creator><creator>Hasan, David</creator><creator>Zarzour, Hekmat</creator><creator>Rosenwasser, Robert H.</creator><creator>Jabbour, Pascal</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8965-2413</orcidid><orcidid>https://orcid.org/0000-0002-1054-9414</orcidid><orcidid>https://orcid.org/0000-0002-3464-5697</orcidid><orcidid>https://orcid.org/0000-0002-2652-2451</orcidid><orcidid>https://orcid.org/0000-0002-7797-1935</orcidid></search><sort><creationdate>202009</creationdate><title>Carotid Blowout Management in the Endovascular Era</title><author>Weinberg, Joshua H. ; Sweid, Ahmad ; Joffe, Daniel ; Piper, Keenan ; Abbas, Rawad ; Hussain, Zubin ; Anderson, Brigitte ; Gooch, Michael Reid ; Herial, Nabeel ; Tjoumakaris, Stavropoula ; Hasan, David ; Zarzour, Hekmat ; Rosenwasser, Robert H. ; Jabbour, Pascal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-899cf461723c8b1c12f31797a2d952d31eb6fe3b8e9c05bb5661410e752d32ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Carotid Artery Diseases - epidemiology</topic><topic>Carotid Artery Diseases - surgery</topic><topic>Carotid blowout</topic><topic>Clinical Neurology</topic><topic>Covered stent</topic><topic>Databases, Factual</topic><topic>Deconstruction</topic><topic>Disease Management</topic><topic>Embolization</topic><topic>Embolization, Therapeutic - adverse effects</topic><topic>Embolization, Therapeutic - methods</topic><topic>Endovascular</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurosciences & Neurology</topic><topic>Reconstruction</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weinberg, Joshua H.</creatorcontrib><creatorcontrib>Sweid, Ahmad</creatorcontrib><creatorcontrib>Joffe, Daniel</creatorcontrib><creatorcontrib>Piper, Keenan</creatorcontrib><creatorcontrib>Abbas, Rawad</creatorcontrib><creatorcontrib>Hussain, Zubin</creatorcontrib><creatorcontrib>Anderson, Brigitte</creatorcontrib><creatorcontrib>Gooch, Michael Reid</creatorcontrib><creatorcontrib>Herial, Nabeel</creatorcontrib><creatorcontrib>Tjoumakaris, Stavropoula</creatorcontrib><creatorcontrib>Hasan, David</creatorcontrib><creatorcontrib>Zarzour, Hekmat</creatorcontrib><creatorcontrib>Rosenwasser, Robert H.</creatorcontrib><creatorcontrib>Jabbour, Pascal</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>World neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weinberg, Joshua H.</au><au>Sweid, Ahmad</au><au>Joffe, Daniel</au><au>Piper, Keenan</au><au>Abbas, Rawad</au><au>Hussain, Zubin</au><au>Anderson, Brigitte</au><au>Gooch, Michael Reid</au><au>Herial, Nabeel</au><au>Tjoumakaris, Stavropoula</au><au>Hasan, David</au><au>Zarzour, Hekmat</au><au>Rosenwasser, Robert H.</au><au>Jabbour, Pascal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carotid Blowout Management in the Endovascular Era</atitle><jtitle>World neurosurgery</jtitle><stitle>WORLD NEUROSURG</stitle><addtitle>World Neurosurg</addtitle><date>2020-09</date><risdate>2020</risdate><volume>141</volume><spage>e1010</spage><epage>e1016</epage><pages>e1010-e1016</pages><issn>1878-8750</issn><eissn>1878-8769</eissn><abstract>Carotid blowout syndrome (CBS) is a potential complication of head and neck cancer, and its therapy is associated with high morbidity and mortality. Recent advances in endovascular techniques have improved patient outcomes. In this study, we report outcomes of emergent endovascular intervention for CBS.
We conducted a retrospective analysis of a prospectively maintained neurovascular database and identified 38 consecutive endovascular procedures for CBS from 2008–2019 at our institution. Data collection was performed on patient demographics, type of cancer, previous cancer treatments, type of CBS, location of bleed, diagnostic workup, endovascular treatment, and procedural outcomes and complications.
A total of 38 consecutive endovascular procedures for CBS were performed from 2008–2019 at our single academic institution. Technical success was achieved in 100% of endovascular procedures. Procedural stroke occurred in 1 (2.6%) procedure, procedural mortality occurred in 1 (2.6%) procedure, recurrent CBS occurred in 4 (10.5%) procedures, and fatal rehemorrhage occurred in 1 (2.6%) procedure. Regarding secondary outcomes, delayed stroke/transient ischemic attack occurred in 1 (2.6%) procedure, whereas there were no cases of delayed infectious complications.
The endovascular treatment of CBS is safe and effective with relatively low rates of morbidity and mortality compared with other currently available treatment modalities. However, the overall rate of complications demands attention and sheds light on the need for further improvement in management.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>32599207</pmid><doi>10.1016/j.wneu.2020.06.151</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8965-2413</orcidid><orcidid>https://orcid.org/0000-0002-1054-9414</orcidid><orcidid>https://orcid.org/0000-0002-3464-5697</orcidid><orcidid>https://orcid.org/0000-0002-2652-2451</orcidid><orcidid>https://orcid.org/0000-0002-7797-1935</orcidid></addata></record> |
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| subjects | Adolescent Adult Aged Carotid Artery Diseases - epidemiology Carotid Artery Diseases - surgery Carotid blowout Clinical Neurology Covered stent Databases, Factual Deconstruction Disease Management Embolization Embolization, Therapeutic - adverse effects Embolization, Therapeutic - methods Endovascular Endovascular Procedures - adverse effects Endovascular Procedures - methods Female Humans Life Sciences & Biomedicine Male Middle Aged Neurosciences & Neurology Reconstruction Retrospective Studies Science & Technology Surgery Treatment Outcome Young Adult |
| title | Carotid Blowout Management in the Endovascular Era |
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