Carotid blowout syndrome as a late complication of carotid stenting in irradiated neck: covered stent treatment using the “No-Touch” technique

Carotid blowout syndrome (CBS) is a potentially fatal condition requiring prompt diagnosis and intervention. CBS primarily affects patients with a history of surgery or irradiation for head and neck malignancies. In this report, we describe a case of CBS in which the carotid artery ruptured 2 months...

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Main Authors: Yohei Takenobu, Noriko Nomura, Yoshito Sugita, Akihiro Okada, Takeshi Kawauchi, Yukinori Terada, Mizuha Toyama, Akihiro Furuta, Hiroomi Nishio, Atsushi Iwakura, Manabu Inoue, Kenji Hashimoto
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Therapeutic Advances in Cardiovascular Disease
Online Access:https://doi.org/10.1177/17539447251366781
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Summary:Carotid blowout syndrome (CBS) is a potentially fatal condition requiring prompt diagnosis and intervention. CBS primarily affects patients with a history of surgery or irradiation for head and neck malignancies. In this report, we describe a case of CBS in which the carotid artery ruptured 2 months after carotid artery stenting in a patient with a previous history of surgery and irradiation for pharyngeal cancer. Although the distance between the orifice of the common carotid artery and the ruptured site was short, the “no-touch” technique —using the Newton-shaped stiff inner catheter (Newton-T ® , Medikit) during the guiding catheter navigation—and snare fixation enabled a stable procedure. Two self-expanding covered stents (GORE ® VIABAHN ® , Gore) covered the ruptured site. Despite adverse conditions, the combination of these techniques led to effective management of impending CBS, a potentially fatal disease. This case report highlights the feasibility of covered stents for CBS and the techniques used for guiding catheter navigation and stabilization throughout the procedure.
ISSN:1753-9455