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Article: Extracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer ‐ Related Carotid Blowout Syndrome

TitleExtracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer ‐ Related Carotid Blowout Syndrome
Authors
KeywordsCarotid blowout syndrome
endovascular
embolization
covered stent
vascular bypass
Issue Date2021
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/
Citation
The Laryngoscope, 2021, v. 131 n. 7, p. 1548-1556 How to Cite?
AbstractObjective/Hypothesis To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer-related carotid blowout syndrome (CBS). Study Design Retrospective case series. Methods Retrospective analysis of clinical data of patients with head and neck cancer-related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results. Results Thrity-seven patients were included. Twenty-five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA-related CBS, the median survival was 6 months, and the 90-day, 1-year, and 2-year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1-month, 6-month, and 2-year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA-related CBS, the median survival was 22.5 months, and the 90-day, 1-year, and 2-year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA-related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment. Conclusions For patients with ICA/CCA-related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred. Level of Evidence 4 Laryngoscope, 131:1548–1556, 2021
DescriptionBronze open access
Persistent Identifierhttp://hdl.handle.net/10722/298775
ISSN
2020 Impact Factor: 3.325
2020 SCImago Journal Rankings: 1.181
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWu, PA-
dc.contributor.authorYuan, GY-
dc.contributor.authorZhou, RM-
dc.contributor.authorHo, WWS-
dc.contributor.authorLu, ZQ-
dc.contributor.authorCai, JF-
dc.contributor.authorYang, SY-
dc.contributor.authorTsang, RKY-
dc.contributor.authorChan, JYW-
dc.date.accessioned2021-04-12T03:03:12Z-
dc.date.available2021-04-12T03:03:12Z-
dc.date.issued2021-
dc.identifier.citationThe Laryngoscope, 2021, v. 131 n. 7, p. 1548-1556-
dc.identifier.issn0023-852X-
dc.identifier.urihttp://hdl.handle.net/10722/298775-
dc.descriptionBronze open access-
dc.description.abstractObjective/Hypothesis To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer-related carotid blowout syndrome (CBS). Study Design Retrospective case series. Methods Retrospective analysis of clinical data of patients with head and neck cancer-related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results. Results Thrity-seven patients were included. Twenty-five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA-related CBS, the median survival was 6 months, and the 90-day, 1-year, and 2-year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1-month, 6-month, and 2-year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA-related CBS, the median survival was 22.5 months, and the 90-day, 1-year, and 2-year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA-related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment. Conclusions For patients with ICA/CCA-related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred. Level of Evidence 4 Laryngoscope, 131:1548–1556, 2021-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/-
dc.relation.ispartofThe Laryngoscope-
dc.rightsSubmitted (preprint) Version This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Accepted (peer-reviewed) Version This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectCarotid blowout syndrome-
dc.subjectendovascular-
dc.subjectembolization-
dc.subjectcovered stent-
dc.subjectvascular bypass-
dc.titleExtracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer ‐ Related Carotid Blowout Syndrome-
dc.typeArticle-
dc.identifier.emailTsang, RKY: rkytsang@hku.hk-
dc.identifier.emailChan, JYW: jywchan1@hku.hk-
dc.identifier.authorityTsang, RKY=rp01386-
dc.identifier.authorityChan, JYW=rp01314-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/lary.29427-
dc.identifier.pmid33571390-
dc.identifier.hkuros322023-
dc.identifier.volume131-
dc.identifier.issue7-
dc.identifier.spage1548-
dc.identifier.epage1556-
dc.identifier.isiWOS:000617008100001-
dc.publisher.placeUnited States-

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