Document Detail

Radiotherapy-induced common carotid pseudoaneurysm presenting with initially occult upper airway hemorrhage and successfully treated by endovascular stent graft.
MedLine Citation:
PMID:  20015736     Owner:  NLM     Status:  MEDLINE    
Radiation induced carotid vasculopathy may present as steno-occlusive disease or less commonly as a pseudoaneurysm. The latter most often presents with a pulsatile mass but is a potential cause of life threatening hemorrhage. We present a case of a small common carotid artery (CCA) pseudoaneurysm that was initially dismissed as the cause of the patients presenting epistaxis given its small size and location. After standard bilateral internal maxillary artery embolizations failed to prevent significant subsequent pharyngeal and tracheal blood loss and serial imaging demonstrated a progressive enlargement of the pseudoaneurysm, a stent graft was successfully placed across the lesion. At five months post stenting, follow-up imaging of the neck showed a stable obliteration of the pseudoaneurysm, good arterial patency, and the patient remained free of recurrent hemorrhage. This case demonstrates that even a small carotid pseudoaneurysm, can present with pharyngeal hemorrhage and should be treated aggressively--with endovascular stent grafting being a preferred treatment modality for arterial lesions in the irradiated neck.
Damien J Ellens; Michael C Hurley; Daniel Surdel; Ali Shaibani; Harold Pelzer; Bernard R Bendok
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-05
Journal Detail:
Title:  American journal of otolaryngology     Volume:  31     ISSN:  1532-818X     ISO Abbreviation:  Am J Otolaryngol     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8000029     Medline TA:  Am J Otolaryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  195-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
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MeSH Terms
Aneurysm, False / etiology,  radiography,  therapy
Carotid Artery Injuries / etiology*,  therapy
Carotid Artery, Common / radiography*
Cerebral Angiography / adverse effects
Embolization, Therapeutic / adverse effects
Hemorrhage / etiology*,  therapy
Radiation Injuries / complications*
Tomography, X-Ray Computed
Treatment Outcome

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