Treatment of Post Neck Radiation Carotid Blowout Syndrome with Viabahn Stent Placement

Carotid blowout syndrome (CBS) is a critical and often fatal complication associated with head and neck malignancies. CBS is characterized by 3 stages as follows: threatened, impending, and acute rupture or hemorrhage. The condition is notably linked with a history of radiotherapy for head and neck cancers, with an incidence of approximately 3-4% among those who have received such treatments. Historically, surgical management of CBS has involved open surgical ligation. However, advancements in endovascular techniques, including endovascular destructive procedures (e.g., coil embolization) and reconstructive procedures (e.g., carotid artery stenting), have become increasingly prevalent. This report presents 2 cases where a self-expandable polytetrafluoroethylene (PTFE)-coated nitinol stent with a heparin coating (Viabahn; Gore and Associates) was utilized in the treatment of CBS.