scholarly journals Carotid blowout syndrome: endovascular management of a lesser known oncological emergency: case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Jitender Singh ◽  
Tarika Sharma ◽  
Taraprasad Tripathy
Keyword(s):  
Early Recognition ◽  
Hemorrhagic Complication ◽  
Emergency Case ◽  
Extracranial Carotid Artery ◽  
Carotid Blowout Syndrome ◽  
Oncological Emergency ◽  
Neck Malignancy ◽  
Endovascular Approach ◽  
Digital Subtraction Angiogram ◽  
Per Oral

Abstract Background Carotid blowout syndrome (CBS) refers to a fatal hemorrhagic complication of cervical carotid arteries that occurs due to rupture of the extracranial carotid artery or one of its major branches in patients treated for head and neck malignancy. In this article, we will discuss two different spectrum of CBS and endovascular approach. Case presentation Two cases of per oral bleeding presented in the emergency department. After patients were hemodynamically stabilized, CT angiography was done which showed type II CBS and type III CBS, respectively. This was followed by transfemoral supra-aortic digital subtraction angiogram coil embolization with scaffolding and anchoring technique, respectively, for the patients. Conclusions Early recognition of the predictors of CBS by a multidisciplinary team is critical. The endovascular treatment approach is relatively safe and effective with low rates of morbidity and mortality compared to surgical approach in CBS.

scholarly journals The Oncological Emergency Case: Paraneoplastic Hypoglycemia in Metastatic Breast Cancer - Case Report and Brief Review of the Literature

Breast Care ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 368-370 ◽  
Author(s):  
Lisa Richters ◽  
Monika Ortmann ◽  
Michael Faust ◽  
Stefan Krämer ◽  
Peter Mallmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Case Report ◽  
Metastatic Breast ◽  
Breast Cancer Case ◽  
Cancer Case ◽  
Review Of The Literature ◽  
Emergency Case ◽  
Oncological Emergency

scholarly journals Open surgery versus endovascular approach in treatment of extracranial carotid artery aneurysms

2018 ◽  
Vol 67 (5) ◽  
pp. 1429-1437 ◽  
Author(s):  
Leng Ni ◽  
Huiling Weng ◽  
Zuo Pu ◽  
Yuehong Zheng ◽  
Bao Liu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Open Surgery ◽  
Extracranial Carotid Artery ◽  
Endovascular Approach

scholarly journals Symptomatic Extracranial Carotid Artery Thrombus: An Indian Experience

2019 ◽  
Vol 10 (02) ◽  
pp. 312-315 ◽  
Author(s):  
Vivek Karan ◽  
Devashish Vyas ◽  
Vikram Bohra ◽  
Vikram Huded
Keyword(s):  
Carotid Artery ◽  
Medical Management ◽  
Large Scale ◽  
Low Molecular Weight ◽  
Digital Subtraction ◽  
Short Term ◽  
Extracranial Carotid Artery ◽  
Indian Experience ◽  
Digital Subtraction Angiogram ◽  
Optimal Regimen

ABSTRACT Introduction: Symptomatic intraluminal carotid artery thrombus (ICT) is an uncommon finding, whose incidence increases with the percentage of stenosis. The optimal treatment modality to address carotid artery thrombus is not well established. We present our data of medical management of carotid artery thrombus with antiplatelet and anticoagulation. Methods: We reviewed our data from January 1, 2016 to December 31, 2017. Patients with extracranial carotid artery thrombus underwent a catheter digital subtraction angiogram to confirm the presence of thrombus. Medical management was done with dual antiplatelets along with low-molecular-weight heparin, and a check angiogram was done after 14 days. Factors contributing to the persistence of thrombus were analyzed. Results: A total of 21 patients diagnosed with acute ischemic stroke and extracranial carotid artery thrombus. Three patients opted for endarterectomy. Eighteen patients underwent medical management. Nine (50%) had a resolution of thrombus. Those with persistent thrombus were significantly older (average age 64 vs. 43 years, P = 0.008). They also had significantly higher proportions of hypertension (100% vs. 44%, P = 0.029), diabetes mellitus (89% vs. 11%, P = 0.003), and underlying carotid stenosis (100% vs. 33%, P = 0.009). Conclusion: Our regimen of dual antiplatelets plus short-term anticoagulation is safe and effective in the management of ICT. Large-scale studies are warranted to determine the optimal regimen and duration of medical treatment.

Type B lactic acidosis: a rare oncological emergency

2020 ◽  
Vol 13 (3) ◽  
pp. e233068
Author(s):  
Qiuying Selina Liu ◽  
Farzana Harji ◽  
Anna Jones ◽  
Amy C Tarnower
Keyword(s):  
Lactic Acidosis ◽  
Early Recognition ◽  
Case Reports ◽  
Type B ◽  
Prompt Treatment ◽  
Oncological Emergency ◽  
The Poor ◽  
First Case ◽  
Metabolic Complication ◽  
Prospective Trials

Type B lactic acidosis is a rare metabolic complication of malignancy, more commonly in haematological malignancies. Due to the lack of formal prospective trials, treatment of lactic acidosis associated with malignancy is based on case reports. Given the poor prognosis, early recognition of type B lactic acidosis and prompt treatment are crucial. We report the first case of type B lactic acidosis in metastatic melanoma, followed by a brief literature review on the proposed pathophysiology and treatment.

Covered Stents for the Prevention and Treatment of Carotid Blowout Syndrome

Neurosurgery ◽  
2015 ◽  
Vol 77 (2) ◽  
pp. 164-167 ◽  
Author(s):  
Brandon G. Gaynor ◽  
Diogo C. Haussen ◽  
Sudheer Ambekar ◽  
Eric C. Peterson ◽  
Dileep R. Yavagal ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Head And Neck ◽  
Perioperative Complications ◽  
Covered Stent ◽  
Covered Stents ◽  
Head And Neck Malignancy ◽  
Presenting Symptoms ◽  
Carotid Blowout Syndrome ◽  
Neck Malignancy ◽  
Ischemic Complications

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.

scholarly journals Carotid blowout syndrome: An oncological emergency less discussed

2017 ◽  
Vol 06 (02) ◽  
pp. 085-086
Author(s):  
Karthik K. Prasad ◽  
Nagesh T. Sirsath ◽  
Kiran V. Naiknaware ◽  
K. Sandhya Rani ◽  
Manish S Bhatia
Keyword(s):  
Carotid Blowout Syndrome ◽  
Oncological Emergency

Pseudoaneurysm of the left internal carotid artery following tonsillectomy

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 491-494 ◽  
Author(s):  
Vávrová ◽  
Slezácek ◽  
Vávra ◽  
Karlová ◽  
Procházka
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Complication ◽  
Left Internal Carotid Artery ◽  
Acute Tonsillitis ◽  
Artery Pseudoaneurysm ◽  
Complete Occlusion ◽  
Endovascular Approach ◽  
Deep Neck Infections

Internal carotid artery pseudoaneurysm is a rare complication of deep neck infections. The authors report the case of a 17-year-old male who presented to the Department of Otorhinolaryngology with an acute tonsillitis requiring tonsillectomy. Four weeks after the surgery the patient was readmitted because of progressive swallowing, trismus, and worsening headache. Computed tomography revealed a pseudoaneurysm of the left internal carotid artery in the extracranial segment. A bare Wallstent was implanted primarily and a complete occlusion of the pseudoaneurysm was achieved. The endovascular approach is a quick and safe method for the treatment of a pseudoaneurysm of the internal carotid artery.

Surgical management of extracranial carotid artery aneurysms

VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Jan Paweł Skóra ◽  
Jacek Kurcz ◽  
Krzysztof Korta ◽  
Przemysław Szyber ◽  
Tadeusz Andrzej Dorobisz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Surgical Management ◽  
Minor Stroke ◽  
Stroke Rate ◽  
Extracranial Carotid Artery ◽  
Long Term Follow Up ◽  
End To End ◽  
Dacron Patch ◽  
Major Stroke

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

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