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Abstract
Background Carotid blowout syndrome is a serious complication of head and neck cancer (HNC) that may involve the intracranial or extracranial internal carotid artery (ICA). Although parent artery occlusion (PAO) is the major endovascular treatment for intracranial carotid blowout syndrome (iCBS), the efficacy of using a balloon-expandable coronary stent-graft (BES) remains unclear.
Methods This was a quasi-randomized trial, prospective study that included patients with iCBS treated by BES or PAO between 2018 and 2024. Patients were allocated to either group based on the last digit of their chart number; even numbers went to the BES group and odd numbers to the PAO group. The inclusion criteria of iCBS included the pathological process of CBS involving petrous and/or cavernous ICA detected by both imaging and clinical features. The primary outcome was defined as rebleeding events after intervention. The secondary outcome was defined as neurological complication after intervention.
Results Fifty-nine patients with 61 iCBS lesions were enrolled. Thirty-three iCBS lesions were treated with BES and 28 underwent PAO. The results for the BES group versus the PAO group, respectively, were: rebleeding events, 5/33 (15.1%) vs 5/28 (17.8%) (p=0.78); neurological complication, 5/33 (15.1%) vs 5/28 (17.8%) (p=0.78); median hemostatic time (months), 10.0 vs 11.5 (p=0.22); and median survival time (months), 10.0 vs 11.5 (p=0.39).
Conclusions No significant difference in rebleeding risk or neurological complication was observed between the BES and PAO groups. Our study confirmed the safety and effectiveness of applying BES for iCBS in HNC patients.
- Intervention
- Stent
- Tumor
Data availability statement
Data are available upon reasonable request.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request.
Footnotes
Contributors K-WY and F-CC designed the data collection tools. K-WY, F-CC, and C-BL monitored data collection for the whole trial. KL and C-HW wrote the statistical analysis plan. T-ML, W-AT, and C-HY cleaned and analyzed the data. K-WY and Y-MK drafted the article. K-WY, KL, C-HW, T-ML, W-AT, C-HY, Y-MK, C-BL, F-CC revised the article. F-CC is the guarantor of this study.
Funding This study has received funding from Taipei Veterans General Hospital, Taiwan (V111B-032, V112B-007 (to CHW); V110C-037, V111C-028, V112C-059, V112D67-002-MY3-1 (to FCC)); Veterans General Hospitals and University System of Taiwan Joint Research Program (VGHUST 109V1-5-2 and VGHUST 110-G1-5-2 (to FCC)); National Science and Technology Council, Taiwan (NSTC 110-2314-B-075-005- and 111-2314-B-075-025-MY3 (to CHW) and 109-2314-B-075-036, 110-2314-B-075-032 and 112-2314-B-075-066- (to FCC)); Yen Tjing Ling Medical Foundation, Taiwan (CI-109-3, CI-111-2, CI-112-2 (to CHW)); Professor Tsuen Chang’s Scholarship Program from Medical Scholarship Foundation in Memory of Professor Albert Ly-Young Shen (to CHW); and Vivian W. Yen Neurological Foundation (to CHW and FCC).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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