Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma

Head & Neck ◽  
2021 ◽  
Author(s):  
Xinni Xu ◽  
Yew Kwang Ong ◽  
Woei Shyang Loh ◽  
Gopinathan Anil ◽  
Qai Ven Yap ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Clinical Predictors

scholarly journals Rupture of an Internal Carotid Artery Pseudoaneurysm after Irradiation for a Nasopharyngeal Carcinoma -Case Report-

2013 ◽  
Vol 116 (5) ◽  
pp. 606-611 ◽  
Author(s):  
Yukiko Hanada ◽  
Hisanori Sasai ◽  
Aya Kamakura ◽  
Megumi Nakamura ◽  
Yoshiharu Sakata ◽  
...  
Keyword(s):  
Case Report ◽  
Nasopharyngeal Carcinoma ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Pseudoaneurysm

Comprehensive Treatment Strategy for Internal Carotid Artery Blowout Syndrome Caused by Nasopharyngeal Carcinoma

2020 ◽  
pp. 019459982096312
Author(s):  
Zhouyang Zhao ◽  
Lijin Huang ◽  
Jinhua Chen ◽  
Weijia Huang ◽  
Xiaobin Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nasopharyngeal Carcinoma ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Retrospective Analysis ◽  
Treatment Strategy ◽  
Internal Carotid ◽  
Comprehensive Treatment ◽  
Stent Group

Objective To evaluate a treatment strategy for internal carotid artery blowout syndrome caused by nasopharyngeal carcinoma. Study Design A retrospective analysis of a case series was performed. Setting Carotid blowout syndrome is a catastrophic complication caused by malignant tumor of the skull base. Methods A retrospective analysis based on 69 patients with internal carotid artery blowout syndrome admitted to our center between April 2018 and January 2020 was performed. The patients were divided into 2 groups: an EBBA (internal carotid artery embolization + bypass based on American Society of Intervention and Therapeutic Neuroradiology/Society of Interventional Radiology [ASITN/SIR]) group and an embolization/stent group. The follow-up time was 6 to 9 months. Results In the EBBA group, 41 patients (41/49, 83.7%) survived. Forty patients had a satisfactory quality of life after 3 months. No death occurred within 3 months. Nonoperative death occurred in 8 cases (8/49, 16.3%). The rate of mortality and disability was 18.4% (9/49). In the embolization/stent group, 16 patients (16/20, 80%) survived. Nonoperative death occurred in 4 cases (4/20, 20%), 3 of which occurred within 1 to 3 months. Four cases reported Modified Rankin Scale ≥2 after 3 months. The rate of mortality and disability was 40% (8/20). Conclusion A comprehensive revascularization strategy for internal carotid artery (ICA) embolization and intracranial and extracranial bypass grafting based on ASITN/SIR score for ICA blowout syndrome patients not only can prolong the patient survival but also greatly improve the survival probability and quality of life as well as reduce their rate of mortality or disability.

Endoscopic Nasopharyngectomy Combined With Internal Carotid Artery Pretreatment for Recurrent Nasopharyngeal Carcinoma

2021 ◽  
pp. 019459982110110
Author(s):  
Zhi-Qiang Wang ◽  
Yu-Long Xie ◽  
You-Ping Liu ◽  
Xiong Zou ◽  
Jin-Hua Chen ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Care Center ◽  
Tertiary Care ◽  
Cancer Center ◽  
Accidental Injury ◽  
Free Survival ◽  
Recurrent Nasopharyngeal Carcinoma

Objective Salvage endoscopic nasopharyngectomy (ENPG) is a reasonable choice for resectable recurrent nasopharyngeal carcinoma (rNPC). However, in past decades, complete removal of the tumor was not feasible when the recurrent lesion was adjacent to the internal carotid artery (ICA). The present article introduces innovative strategies to ensure sufficient surgical margins while avoiding accidental injury to the ICA. Study Design Retrospective study. Setting Tertiary care center. Methods We retrospectively reviewed rT2-3 rNPC patients with tumor lesions adjacent to the ICA (<5 mm) who underwent ENPG at the Sun Yat-sen University Cancer Center between January 2015 and June 2020. Thirty-seven patients were selected for this study. Seventeen patients underwent ENPG using direct dissection, 10 patients underwent endoscopic-assisted transcervical protection of the parapharyngeal ICA combined with ENPG, and 10 patients underwent ICA embolization followed by ENPG. Results With a median follow-up duration of 31 months (range, 5 to 53 months), the 2-year overall survival, progression-free survival, locoregional recurrence-free survival, and distant metastasis-free survival rates of salvage ENPG for rNPC adjacent to the ICA were 88.7%, 72.0%, 72.0%, and 97.3%, respectively. The incidences of grade 1-2 and grade 3-5 postoperative complications were 16.2% and 13.5%, respectively. Two patients experienced ICA rupture during direct dissection but were out of danger after vascular embolization therapy. One patient had a positive margin. Two patients had severe nasopharyngeal wound infections with mucosal flap necrosis. Conclusion ENPG combined with ICA pretreatment allows the feasible and effective resection of rNPC lesions adjacent to the ICA.

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