Acute Internal Carotid Artery Rupture (Carotid Blow Out): Emergency Treatment by Endovascular Coil Occlusion of Carotid Artery

Abstract

Italian

We report a rare case of acute internal carotid artery rupture following radical resection and radiotherapy for an ulcerative carcinoma of the tongue. The patient presented with acute bleeding from the post operative site two weeks following radiotherapy. A surgical pressure bandage was placed and angiography was performed. There was a massive bleed from the ICA once the dressing was removed. The common carotid and internal carotid arteries were occluded with platinum 0.035 coils placed rapidly and the bleeding stopped. As the collateral circulation was good, the patient had no neurological deficits.

There are only a few case reports of carotid blow out (carotid rupture) in literature. Most of the cases are treated by either surgery or endovascular detachable balloons. To our knowledge, this is the first case where microcoils were used to treat carotid blow out.

Keywords

carotid artery rupture detachable coils endovascular treatment

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References

Hirai

Korogi

: Emergency balloon embolization for carotid artery rupture secondary to postoperative infection. Cardiovasc Intervent Radiol 19(1): 50–52, 1996.

Ampil

Ghali

: Effects of postoperative external beam irradiation after carotid artery stripping of nodal metastasis. J Oral Maxillofac Surg 56(7): 845–848, discussion 848–849, 1998.

Chaloupka

Putman

: Endovascular therapy for the carotid blowout syndrome in head and neck surgical patients: diagnostic and managerial considerations. Am J Neuroradiol 17(5): 843–52, 1996.

Prendergast

Kuo

: Spontaneous rupture of the common carotid artery with pseudoaneurysm formation. Ann Emerg Med 30(2): 230–233, 1997.

Porcellini

Bernardo

: Iatrogenic rupture of internal carotid artery aneurysm. A complication of CT-guided needle biopsy of the neck. G Chir 17(10): 531–533, 1996.

Karov

: Spontaneous rupture of an internal carotid artery aneurysm diagnosed as a peritonsillar abscess, a tonsillar and epipharyngeal carcinoma with metastasis. Folia Med (Plovdiv) 38(2): 65–67, 1996.

Buerger

Meyer

: Ruptured cervical aneurysm of the carotid artery case report of a rare disease. Vasa 27(2): 122–124, 1998.

Friedman

Evangelisti

: Postoperative carotid artery rupture caused by actinomyces infection. Otolaryngol Head Neck Surg 114(1): 145–147, 1996.

Graves

Peri

John

II : Endovascular occlusion of the carotid or vertebral artery with temporary proximal flow arrest and microcoils: Clinical results. Am J Neuroradiol 18: 1201–1206, 1997.

10.

Chaloupka

Roth

: Recurrent carotid blowout syndrome: diagnostic and therapeutic challenges in a newly recognized subgroup of patients. Am J Neuroradiol 20(6):1069–77, 1999.