Postoperative Carotid Blow-out

초록

KQ 19.1. In patients diagnosed with advanced head and neck cancer, significant bleeding can occur due to vessel damage caused by direct tumor infiltration or abnormalities in intravascular coagulation. Thorough preparation is essential to address both the medical and psychological aspects of bleeding. Considering the various potential causes of bleeding, identifying the underlying cause is crucial, and developing strategies for managing acute life-threatening bleeding while also preventing subsequent complications that may adversely affect the patient’s chances of survival is equally important. KQ 19.2. Endovascular treatment is often considered for carotid blow-out caused by arterial wall necrosis after radiation therapy for head and neck cancer. In clinical practice, the endovascular treatment of carotid blow-out is performed as shown below (Fig. 19.3). KQ 19.3. Carotid blow-out is a severe and potentially fatal complication associated with head and neck surgery. It can occur in patients who have undergone prior radiation therapy and in those with a history of neck dissection, mucocutaneous fistula, flap necrosis, wound infection, poor nutrition, unhealthy supporting tissue, and recurrent tumors (Chaloupka et al. AJNR Am J Neuroradiol, 17(5): 843–52, 1996; Powitzky et al. Ann Otol Rhinol Laryngol, 119(7): 476–84, 2010). © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd..