Department of Radiology, Albert Einstein College of Medicine, Bronx, New York 10463, USA.
J Neurointerv Surg. 2012 Nov;4(6):426-34. doi: 10.1136/neurintsurg-2011-010083. Epub 2011 Oct 7.
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.
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.
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.
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.
本研究旨在回顾覆盖支架在双侧头颈部血管神经结构受威胁的鳞癌患者中的应用。
通过放射学信息系统，检索了 2006 年至 2009 年间在颈动脉血管中使用覆盖支架治疗双侧头颈部癌的所有患者。共确定了 5 名患者（1 名女性），平均年龄 60.5 岁（范围 45-69 岁）。所有患者均因头颈部鳞癌的初始治疗后出现颈动脉破裂综合征，随后肿瘤复发或转移立即威胁到双侧颈动脉。放置了覆盖支架。长期随访包括临床进展、支架通畅性的验证以及在第一个月后通过超声或增强 CT 检测肿瘤进展，然后每 3-6 个月进行一次。所有患者在治疗后均接受抗血小板治疗。
所有患者均安全地放置了覆盖支架。平均生存期为 5 个月，1 例外患者存活 3 年。无后续不可控制的出血。
对于双侧颈动脉受威胁的头颈部肿瘤患者，使用覆盖支架以避免灾难性出血的治疗是成功的。
