Threatened carotid artery rupture: a complication of radical neck surgery.

Carotid artery rupture is an infrequent but highly dangerous postoperative complication of radical head and neck surgery. The principal predisposing factors are radiation therapy, infection, tissue necrosis, vessel exposure, and pharyngeal fistula formation. Actual or threatened carotid artery rupture has been most commonly managed by ligation of the involved vessel. We present a patient who showed signs of impending carotid artery rupture after both irradiation and radical neck surgery. Balloon embolization was employed in preference to traditional carotid artery ligation. The patient's risk factors for carotid artery rupture are analyzed and the application of balloon embolization is discussed.