Article

Patients with head and neck cancers and associated postirradiated carotid blowout syndrome: Endovascular therapeutic methods and outcomes

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Journal of Vascular Surgery (Impact Factor: 2.98). 05/2008; 47(5):936-45. DOI: 10.1016/j.jvs.2007.12.030
Source: PubMed

ABSTRACT This study retrospectively evaluated the technical and hemostatic outcomes of reconstructive and deconstructive endovascular management in patients with head and neck cancers associated with carotid blowout syndrome (CBS).
Twenty-four patients with head and neck cancers with CBS involving the main trunk of carotid artery underwent endovascular therapy. This included reconstructive management with self-expandable stent grafts to preserve the diseased carotid artery in 11 patients and deconstructive management with balloons, coils, or acrylic adhesives to occlude the diseased carotid artery in 13 patients. Based on clinical severity and therapeutic priority, we classified CBS in our patients into two groups: acute or impending and threatened. The angiographic severity was graded from 0 to 3. Evaluation of technical outcome included technical success, initial and delayed complications, and patency of stent graft in the reconstructive group. The hemostatic outcome was evaluated by immediate hemostatic result, rebleeding, and duration of hemostasis. Sex, age, clinical and angiographic severities, local wound complications, and location of the pathologic lesion were examined as predictors of the technical and hemostatic outcomes of endovascular management by using Cox regression method.
Technical success and immediate hemostasis were achieved in all patients of both groups. Initial complications during the procedures were encountered in four patients (36.4%) who underwent reconstructive management and in one patient (7.7%) who underwent deconstructive management (P = .142). Delayed complications during the follow-up were seen in one patient (9.1%) with reconstructive management and one patient (7.7%) with deconstructive management (P > .99). Rebleeding occurred in five patients (45.5%) in the reconstructive management group and in three patients (23.1%) in the deconstructive management group (P = .659). The mean duration of hemostasis after initial reconstructive and deconstructive management was 4.0 +/- 8.1 and 8.5 +/- 10.1 months, respectively (P = .249). Rebleeding was noted in 7 of 11 patients (63.6%) with acute CBS and in 1 of 13 patients (7.7%) with impending and threatened CBS (P = .008).
There is no significant difference in technical and hemostatic outcomes between the reconstructive and deconstructive endovascular management methods. Hemostatic results were influenced by clinical severity. The rebleeding rate is higher in patients with advanced and acute clinical severity.

Download full-text

Full-text

Available from: Wan-Yuo Guo, Aug 13, 2015
0 Followers
  • [Show abstract] [Hide abstract]
    ABSTRACT: An approach to enhance the flexibility of communication between dissimilar CAD/CAM systems is presented. The proposed method involves techniques that have recently become available from STEP, the emerging ISO standard for the exchange of product data. The key principle of the approach is the specification of the entity domains of the interconnect CAD/CAM systems in the EXPRESS language. If a database system is applied as a central storage facility for the involved systems, then the required database schemes as well as the access software can be automatically derived from the EXPRESS definitions. Results from experiments with a data link between a commercial CAD/CAM system and a commercial database system are presented
    Computers and Communications, 1992. Conference Proceedings., Eleventh Annual International Phoenix Conference on; 05/1992
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this paper PROFINET, the new industrial real-time Ethernet protocol, is considered. PROFINET has been designed to cover all sectors of distributed automation, from process control, to distributed I/O and to motion control. After an overview of Ethernet limitations, the different kinds of PROFINET are presented followed by experimental results. Authors have realized a test environment to achieve proper timing measure over a PROFINET network assembled with now available and future components. Preliminary results show that PROFINET Non-RT protocol can integrate existing fieldbus plant, whereas PROFINET RT Class 1 protocol has a good real-time behavior with cycle variability less than 10% even in high-loaded network condition.
    Factory Communication Systems, 2004. Proceedings. 2004 IEEE International Workshop on; 10/2004
  • Journal of vascular and interventional radiology: JVIR 11/2009; 21(1):161-2. DOI:10.1016/j.jvir.2009.09.017 · 2.15 Impact Factor
Show more