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Covered stents safely utilized to prevent catastrophic hemorrhage in patients with advanced head and neck malignancy
  1. Todd Miller1,2,
  2. Judah Burns1,2,
  3. Joaquim Farinhas1,2,
  4. David Pasquale1,2,
  5. Amit Haboosheh3,
  6. Jacqueline A Bello1,2,
  7. Allan Brook1,2
  1. 1Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
  2. 2Montefiore Medical Center, Bronx, New York, USA
  3. 3Sackler School of Medicine, Tel Aviv, Israel
  1. Correspondence to Dr Todd Miller, Department of Radiology, Albert Einstein College of Medicine, Bronx, NY 10463, USA; tmiller{at}montefiore.org

Abstract

Purpose The purpose of this study was to review the use of covered stents in patients with squamous cell carcinoma of the head and neck threatening bilateral neurovascular structures.

Methods The radiology information system was searched for all patients with bilateral head and neck carcinoma treated with covered stents in the carotid vasculature from 2006 through 2009. Five patients (one woman) of mean age 60.5 years (range 45–69) were identified. All had carotid blowout syndrome after treatment for primary squamous cell carcinoma of the head and neck with subsequent tumor recurrence or metastases immediately threatening bilateral carotid vasculature. Covered stents were placed. Long-term follow-up included clinical progress, verification of stent patency and detection of tumor progression via ultrasound or contrast-enhanced CT after the first month and then every 3–6 months. All patients were maintained on antiplatelet medication after treatment.

Results Covered stents were safely deployed in all patients. Mean survival was 5 months with one outlier surviving for 3 years. There were no subsequent uncontrollable hemorrhages.

Conclusion The use of covered stents for avoidance of catastrophic hemorrhage following treatment in patients with head and neck tumors with bilaterally threatened carotid arteries was successful.

  • Hemorrhage
  • intervention
  • stent
  • CT angiography
  • angioplasty
  • device
  • neck
  • neoplasm
  • technique
  • angiography
  • MRI
  • thrombectomy
  • technique
  • complication

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Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Montefiore Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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