Rescue of postoperative carotid blowout in head and neck neoplasms / 中华耳鼻咽喉头颈外科杂志
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
; (12): 410-413, 2010.
Article
en Zh
| WPRIM
| ID: wpr-276454
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the prevention and rescuing measures of postoperative fatal bleeding induced by carotid blowout in head and neck tumors.</p><p><b>METHODS</b>Seven cases with postoperative carotid bleeding treated from October 2003 to August 2009 were reviewed retrospectively. Of the patients, 6 were with common carotid blowout and one with internal carotid artery blowout. All patients underwent pre- or post-operative radiotherapy for primary head and neck tumours and 3 patients had neck defect repair with deltopectoral skin flap, frontal flap or free radial arm flap respectively. After carotid blowout bleeding, the patients were treated in time with X ray transcatheter intervention including transcatheter arterial embolization (TAE) and self-expanding covered stent implantation, followed by repairing the carotid region with appropriate myocutaneous flaps.</p><p><b>RESULTS</b>Of 7 patients with carotid blowout, 5 patients were successfully rescued with X ray transcatheter intervention, of them 2 with self-expanding covered stent implantation and 2 with TAE respectively, and other 2 patients died due to rapid bleeding. Of the successfully rescued patients, 2 patients were with the repair of carotid area by pectoralis major myocutaneous flap, one by submental flap and one by local flap, but another one not with flap repair. Follow-up showed the 3 patients rescued with self-expanding covered stent implantation were survival for 6, 12, and 20 months, respectively, and the 2 patients rescued with TAE died of repeated carotid blowout in 2 and 13 months later, respectively.</p><p><b>CONCLUSIONS</b>The planned and timely X ray transcatheter intervention is an effective method to treat carotid blowout bleeding in the patients underwent head and neck tumour surgeries. Compared with TAE, self-expanding covered stent implantation may be more reliable for restoring the blood supply of head and neck region, with less complications. One-stage repair of carotid region with myocutaneous flap is of great importance to protect the carotid and to promote the wound healing.</p>
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Índice:
WPRIM
Asunto principal:
Rotura Espontánea
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Cirugía General
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Terapéutica
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Procedimientos Quirúrgicos Vasculares
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Estudios Retrospectivos
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Hemorragia Posoperatoria
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Traumatismos de las Arterias Carótidas
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Embolización Terapéutica
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Neoplasias de Cabeza y Cuello
Tipo de estudio:
Observational_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
Idioma:
Zh
Revista:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Año:
2010
Tipo del documento:
Article