Update on endovascular management of the carotid blowout syndrome

Carotid blowout syndrome can be a life-threatening late complication of surgical and radiation therapy for head and neck tumors in the vicinity of the cervical carotid artery. The syndrome spans a spectrum of pathology from impending to acute rupture of the artery. These cases are uncommon, can be dramatic in terms of blood loss, and are often true emergencies. The optimal management of these patients requires quick recognition, and often advanced trauma life-support skills and creative endovascular solutions. Definitive endovascular treatment is the therapy of choice in this condition; open surgical options are very limited. In this article, we present some background information regarding the clinical and pathologic aspects of the syndrome and our experience in endovascular management.