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Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure

INTRODUCTION: Carotid blowout syndrome (CBS) secondary to radiation therapy is life-threatening and requires emergency treatment. More recently, endovascular treatment has provided an effective way to control CBS-related bleeding. CASE DESCRIPTION: We present a case of CBS with a rupture of the inte...

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Autores principales: Dong, Fei, Li, Qian, Wu, JianJun, Zhang, MinMing, Zhang, GuangQiang, Li, Bin, Jin, Kai, Min, Jie, Liang, WeiRen, Chao, Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021652/
https://www.ncbi.nlm.nih.gov/pubmed/27652126
http://dx.doi.org/10.1186/s40064-016-3209-y
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author Dong, Fei
Li, Qian
Wu, JianJun
Zhang, MinMing
Zhang, GuangQiang
Li, Bin
Jin, Kai
Min, Jie
Liang, WeiRen
Chao, Ming
author_facet Dong, Fei
Li, Qian
Wu, JianJun
Zhang, MinMing
Zhang, GuangQiang
Li, Bin
Jin, Kai
Min, Jie
Liang, WeiRen
Chao, Ming
author_sort Dong, Fei
collection PubMed
description INTRODUCTION: Carotid blowout syndrome (CBS) secondary to radiation therapy is life-threatening and requires emergency treatment. More recently, endovascular treatment has provided an effective way to control CBS-related bleeding. CASE DESCRIPTION: We present a case of CBS with a rupture of the internal carotid artery (ICA) pseudo-aneurysm after Gamma Knife radiation therapy for nasopharyngeal carcinoma (NPC). The patient was a 55-year-old man who was transferred to our hospital with severe repetitive epistaxis. He had a history of NPC and had been treated with Gamma Knife radiation therapy 7 months prior, with a central dose of 32 Gy and marginal dose of 16 Gy. As CBS was confirmed by angiography, and the affected part of the ICA lumen exhibited moderate stenosis, the patient was successfully treated by ICA occlusion after stent implantation failure. The patient died 40 months after this operation from tumor recurrence, but without epistaxis during follow up. DISCUSSION AND EVALUATION: Quick selection of an appropriate treatment method is very important for an acute CBS patient. CONCLUSION: ICA occlusion can be directly considered for an acute CBS patient, if the affected ICA exhibits stenosis that is moderate or above.
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spelling pubmed-50216522016-09-20 Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure Dong, Fei Li, Qian Wu, JianJun Zhang, MinMing Zhang, GuangQiang Li, Bin Jin, Kai Min, Jie Liang, WeiRen Chao, Ming Springerplus Case Study INTRODUCTION: Carotid blowout syndrome (CBS) secondary to radiation therapy is life-threatening and requires emergency treatment. More recently, endovascular treatment has provided an effective way to control CBS-related bleeding. CASE DESCRIPTION: We present a case of CBS with a rupture of the internal carotid artery (ICA) pseudo-aneurysm after Gamma Knife radiation therapy for nasopharyngeal carcinoma (NPC). The patient was a 55-year-old man who was transferred to our hospital with severe repetitive epistaxis. He had a history of NPC and had been treated with Gamma Knife radiation therapy 7 months prior, with a central dose of 32 Gy and marginal dose of 16 Gy. As CBS was confirmed by angiography, and the affected part of the ICA lumen exhibited moderate stenosis, the patient was successfully treated by ICA occlusion after stent implantation failure. The patient died 40 months after this operation from tumor recurrence, but without epistaxis during follow up. DISCUSSION AND EVALUATION: Quick selection of an appropriate treatment method is very important for an acute CBS patient. CONCLUSION: ICA occlusion can be directly considered for an acute CBS patient, if the affected ICA exhibits stenosis that is moderate or above. Springer International Publishing 2016-09-13 /pmc/articles/PMC5021652/ /pubmed/27652126 http://dx.doi.org/10.1186/s40064-016-3209-y Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Study
Dong, Fei
Li, Qian
Wu, JianJun
Zhang, MinMing
Zhang, GuangQiang
Li, Bin
Jin, Kai
Min, Jie
Liang, WeiRen
Chao, Ming
Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
title Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
title_full Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
title_fullStr Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
title_full_unstemmed Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
title_short Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
title_sort carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure
topic Case Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021652/
https://www.ncbi.nlm.nih.gov/pubmed/27652126
http://dx.doi.org/10.1186/s40064-016-3209-y
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