gms | German Medical Science

83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2012, Mainz

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Covered stents for hemostasis in life-threatening hemorrhage by carotid blowout syndrome in patients with head and neck cancer

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  • corresponding author Christian Plettenberg - Univ. HNO-Klinik, Düsseldorf, Germany
  • presenting/speaker Thomas Klenzner - Univ. HNO-Klinik, Düsseldorf, Germany
  • presenting/speaker Kathrin Scheckenbach - Univ. HNO-Klinik, Düsseldorf, Germany
  • presenting/speaker K. Rybacki - Inst. für Diagnostische und Interventionelle Radiologie, Düsseldorf, Germany
  • presenting/speaker Bernd Turowski - Inst. für Diagnostische und Interventionelle Radiologie, Düsseldorf, Germany
  • presenting/speaker Jörg Handschel - Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum, Düsseldorf, Germany
  • presenting/speaker Christiane Matuschek - Univ. Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Düsseldorf, Germany
  • presenting/speaker Jörg Schipper - Univ. HNO-Klinik, Düsseldorf, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hno14

doi: 10.3205/12hno14, urn:nbn:de:0183-12hno149

Veröffentlicht: 23. Juli 2012

© 2012 Plettenberg et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

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Text

Background and Purpose: Carotic blow out syndromes (CBS) by radionecrosis or tumor infiltration are rare events in patients with head and neck cancer. Intervention to binding or sewing over the bleeding vessel is associated with a mortality/morbidity of ~40%/~60%. By the use of Covert-stents (CS), the blood flow is continuously maintained and therefore cerebral complications are decreased. We investigated the safety and efficacy of intraluminal vascular stents to control these acute life-threatening bleeding.

Materials and Methods: We retrospectively evaluated the patient's history of 5 patients (4 ♂, 1 ♀). All had a history of head and neck cancer treatment and were treated acutely for a life-threatening bleeding from the carotid artery (ACC) or internal carotid artery (ACI).

Results: The analysis showed arrosion of the ACI/ACC in 2 patiens by tumor and in 3 patients by radionecrosis. In 4 patients, immediate hemostasis was achieved by implantation of a CS. In one patient the placment of a CS failed and decision for an interposition of a carotid graft was made. Periprocedural complications were observed: Neurological deficits (hemiplegia) directly occurred in 1 of 5 patients postinterventional, but are to be regarded more as a result of the massive bleeding. 4 of 5 patients died of their underlying condition in the following months, but mortality was not related to the CS or the intervention.

Conclusions: Acute life-threatening bleeding from the ACC or ACI with advanced disease in patients with head and neck cancers can be treated safely and effectively with CS.