Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome

Brandon G. Gaynor, Diogo C. Haussen, Sudheer Ambekar, Eric Peterson, Dileep R Yavagal, Mohamed Elhammady

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND: Carotid blowout syndrome (CBS) is a life-threatening emergency resulting from compromise of the carotid artery caused by malignancy in the head and neck. OBJECTIVE: To report our experience with covered stents for the prevention or treatment of carotid blowout syndrome secondary to head and neck cancer to ascertain the safety and efficacy of this technique. METHODS: We reviewed the characteristics and outcome of all patients who underwent covered stent placement in the extracranial carotid artery in the setting of head and neck malignancy between 2006 and 2013 at the University of Miami. Patient demographics, presenting symptoms, devices used, perioperative complications, imaging, and follow-up data were reviewed. RESULTS: Seventeen carotids in 15 patients, whose ages ranged from 20 to 84 years (mean, 70.4 years), were treated with 20 covered nitinol (Viabahn Endoprosthesis, Gore, Flagstaff, Arizona) stents. Three patients were treated acutely for bleeding from carotid blowout, and 12 were treated prophylactically for threatened carotid blowout. All patients were given periprocedural dual antiplatelet therapy. No thromboembolic or ischemic complications were noted. Hemorrhage after treatment occurred in 4 patients. In 2 patients, the hemorrhage was from a source not covered by the stent. CONCLUSION: The use of covered stents is a simple, safe, and effective method for treating or preventing carotid blowout syndrome in patients with head and neck malignancy. Carotid artery reconstruction with covered stents may minimize the risk of ischemic complications associated with endovascular or surgical carotid sacrifice. Abbreviation: CBS, carotid blowout syndrome ©

Original languageEnglish (US)
Pages (from-to)164-167
Number of pages4
JournalNeurosurgery
Volume77
Issue number2
DOIs
StatePublished - Aug 20 2015

Fingerprint

Stents
Carotid Arteries
Neck
Head
Therapeutics
Hemorrhage
Neoplasms
Head and Neck Neoplasms
Emergencies
Demography
Safety
Equipment and Supplies

Keywords

  • Carotid blowout
  • Covered stent
  • Viabahn

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Gaynor, B. G., Haussen, D. C., Ambekar, S., Peterson, E., Yavagal, D. R., & Elhammady, M. (2015). Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome. Neurosurgery, 77(2), 164-167. https://doi.org/10.1227/NEU.0000000000000738

Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome. / Gaynor, Brandon G.; Haussen, Diogo C.; Ambekar, Sudheer; Peterson, Eric; Yavagal, Dileep R; Elhammady, Mohamed.

In: Neurosurgery, Vol. 77, No. 2, 20.08.2015, p. 164-167.

Research output: Contribution to journalArticle

Gaynor, BG, Haussen, DC, Ambekar, S, Peterson, E, Yavagal, DR & Elhammady, M 2015, 'Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome', Neurosurgery, vol. 77, no. 2, pp. 164-167. https://doi.org/10.1227/NEU.0000000000000738
Gaynor, Brandon G. ; Haussen, Diogo C. ; Ambekar, Sudheer ; Peterson, Eric ; Yavagal, Dileep R ; Elhammady, Mohamed. / Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome. In: Neurosurgery. 2015 ; Vol. 77, No. 2. pp. 164-167.
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