Abstract

Objective. To analyse the prognosis of carotid blowout syndrome (CBS) after endovascular interventions in patients with head and neck cancer.
Methods. We conducted a retrospective study at a tertiary centre (2000-2019), including demographics, medical history, treatment details, and outcomes of CBS.
Results. Among 44 patients with CBS (32 males, 12 females; mean age 65 ± 14 years), squamous cell carcinoma histotype and laryngeal localisation were most common, with 84% having advancedstaged disease. Significant risk factors included prior surgery (70%), neck dissection (48%), radiation (55%), and chemotherapy (66%). Pharyngocutaneous fistula and tracheostomy were present in 32% and 57% of cases, respectively. Radiological findings showed threatened bleeding (62%), sentinel bleeding (11%), and acute rupture (27%). Endovascular treatment achieved haemostasis in 95% of cases, with an 11% rate of acute ischaemic complications. Six-month survival was 28%, with 66% of deaths due to disease progression. Recurrent bleeding occurred in 16% of cases.
Conclusions. CBS is a severe complication with a high risk of rebleeding. Endovascular interventions effectively manage bleeding with low rates of complication.

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Aiman Elmograbi - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel

Nir Tsur - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel. Corresponding author - nirtsur19@gmail.com

Yonatan Reuven - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel

Eyal Yosefof - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel

Eli Perlow - Department of Radiology, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel

Thomas Shpitzer - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel

Esmat Najjar - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel

Gideon Bachar - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel

Aron Popovtzer - Sharett Institute of Oncology, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel. AM and AP contributed equally to the work.

Aviram Mizrachi - Department of Head and Neck Otolaryngology Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel Aviv University, Israel. AM and AP contributed equally to the work.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Copyright (c) 2025 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale

How to Cite
Elmograbi, A., Tsur, N., Reuven, Y., Yosefof, E., Perlow, E. ., Shpitzer, T., Najjar, E., Bachar, G., Popovtzer, A., & Mizrachi, A. . (2025). Prognosis of patients with carotid blowout syndrome in the era of endovascular interventions. ACTA Otorhinolaryngologica Italica, 45(6), 380–387. https://doi.org/10.14639/0392-100X-A948
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