Chen Yao Liang, Wong Ho Fai, Ku Yi Kang, Wong Alex Mun Ching, Wai Yau Yau, Ng Shu Hang
Department of Medical Imaging, Chang Gung Memorial Hospital, Keelung, Chang Gung University -
Interv Neuroradiol. 2008 Nov 11;14 Suppl 2(Suppl 2):23-7. doi: 10.1177/15910199080140S206. Epub 2009 Jan 2.
Carotid blowout is a devastating complication in patients with head and neck cancer, commonly encountered as a delayed complication of radiation therapy. The clinical outcomes in patients with carotid blowout are discouraging; even transarterial embolization has been performed to control the acute massive bleeding. In recent years, covered stents have been reported as an alternative treatment producing favorable results. In this study, 13 consecutive patients with acute carotid blowout syndrome were treated at our institute by covered-stent reconstruction between December 2005 and December 2007. The median posthemorrhagic survival period after reconstruction (187 days) was more than that reported in patients treated only with transarterial embolization (26 days). Though the estimated mortality was about 54%, those who survived showed favorable outcomes, and only one transit complication of acute in-stent thrombosis occurred. Thus, endovascular covered-stent reconstruction is a safe and effective approach to manage acute carotid blowout syndrome.
颈动脉破裂是头颈部癌症患者中一种极具破坏性的并发症，通常是放射治疗的延迟并发症。颈动脉破裂患者的临床预后令人沮丧；甚至已采用经动脉栓塞来控制急性大出血。近年来，有报道称覆膜支架作为一种替代治疗方法取得了良好效果。在本研究中，2005年12月至2007年12月期间，我院对13例连续性急性颈动脉破裂综合征患者进行了覆膜支架重建治疗。重建后出血后的中位生存期（187天）比仅接受经动脉栓塞治疗的患者报告的生存期（26天）更长。尽管估计死亡率约为54%，但存活者显示出良好的预后，且仅发生了1例急性支架内血栓形成的短暂并发症。因此，血管内覆膜支架重建是治疗急性颈动脉破裂综合征的一种安全有效的方法。
