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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 4/2017

01-04-2017 | Clinical Investigation

Endovascular Management of Patients with Head and Neck Cancers Presenting with Acute Hemorrhage: A Single-Center Retrospective Study

Authors: P. P. Vilas Boas, L. H. de Castro-Afonso, L. M. Monsignore, G. S. Nakiri, F. V. de Mello-Filho, D. G. Abud

Published in: CardioVascular and Interventional Radiology | Issue 4/2017

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Abstract

Purpose

Acute hemorrhage associated with cancers of the head and neck is a life-threatening condition that requires immediate action. The aim of this study was to assess the safety and efficacy of endovascular embolization for acute hemorrhage in patients with head and neck cancers.

Materials and Methods

Data were retrospectively collected from patients with head and neck cancers who underwent endovascular embolization to treat acute hemorrhage. The primary endpoint was the rate of immediate control of hemorrhage during the first 24 h after embolization. The secondary endpoints were technical or clinical complications, rate of re-hemorrhage 24 h after the procedure, time from embolization to re-hemorrhage, hospitalization time, mortality rate, and time from embolization to death.

Results

Fifty-one patients underwent endovascular embolization. The primary endpoint was achieved in 94% of patients. The rate of technical complications was 5.8%, and no clinical complication was observed. Twelve patients (23.5%) had hemorrhage recurrence after an average time of 127.5 days. The average hospitalization time was 7.4 days, the mortality rate during the follow-up period was 66.6%, and the average time from embolization to death was 132.5 days.

Conclusion

Endovascular embolization to treat acute hemorrhage in patients with head and neck cancers is a safe and effective method for the immediate control of hemorrhage and results in a high rate of hemorrhage control. Larger studies are necessary to determine which treatment strategy is best for improving patient outcomes.
Literature
1.
Ubogagu E, Harris DG. Guideline for the management of terminal haemorrhage in palliative care patients with advanced cancer discharged home for end-of-life care. BMJ Support Palliat Care. 2012;2:294–300.CrossRefPubMed
2.
Harris DG, Noble SI. Management of terminal hemorrhage in patients with advanced cancer: a systematic literature review. J Pain Symptom Manag. 2009;38:913–27.CrossRef
3.
4.
5.
Ringash J. Survivorship and quality of life in head and neck cancer. J Clin Oncol. 2015;33:3322–7.CrossRefPubMed
6.
Self EM, Bumpous J, Ziegler C, et al. Risk factors for hemorrhage after chemoradiation for oropharyngeal squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg. 2013;139:356–61.CrossRefPubMed
7.
Hessén Söderman AC, Ericsson E, Hemlin C, Hultcrantz E, Månsson I, Roos K, Stalfors J. Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54,696 operations. Laryngoscope. 2011;121:2322–6.CrossRefPubMed
8.
Kakizawa H, Toyota N, Naito A, Ito K. Endovascular therapy for management of oral hemorrhage in malignant head and neck tumors. Cardiovasc Intervent Radiol. 2005;28(6):722–9.CrossRefPubMed
9.
Sesterhenn AM, Iwinska-Zelder J, Dalchow CV, et al. Acute haemorrhage in patients with advanced head and neck cancer: value of endovascular therapy as palliative treatment option. J Laryngol Otol. 2006;120:117–24.CrossRefPubMed
10.
Chou WC, Lu CH, Lin G, et al. Transcutaneous arterial embolization to control massive tumor bleeding in head and neck cancer: 63 patients’ experiences from a single medical center. Support Care Cancer. 2007;15:1185–90.CrossRefPubMed
11.
Chen YF, Lo YC, Lin WC, et al. Transarterial embolization for control of bleeding in patients with head and neck cancer. Otolaryngol Head Neck Surg. 2010;142:90–4.CrossRefPubMed
12.
Rzewnicki I, Kordecki K, Lukasiewicz A, et al. Palliative embolization of hemorrhages in extensive head and neck tumors. Pol J Radiol. 2012;77:17–21.CrossRefPubMedPubMedCentral
13.
George B, Casasco A, Deffrennes D, et al. Intratumoral embolization of intracranial and extracranial tumors: technical note. Neurosurgery. 1994;35:771–3.CrossRefPubMed
14.
Zhao L-B, Shi HB, Park S, et al. Acute bleeding in the head and neck: angiographic findings and endovascular management. AJNR Am J Neuroradiol. 2014;35:360–6.CrossRefPubMed
15.
Roh JL, Suh DC, Kim MR, et al. Endovascular management of carotid blowout syndrome in patients with head and neck cancers. Oral Oncol. 2008;44:844–50.CrossRefPubMed
16.
Lesley WS, Chaloupka JC, Weigele JB, et al. Preliminary experience with endovascular reconstruction for the management of carotid blowout syndrome. AJNR Am J Neuroradiol. 2003;24:975–81.PubMed
17.
Luo CB, Chang FC, Teng MM, et al. Endovascular treatment of the carotid artery rupture with massive hemorrhage. J Chin Med Assoc. 2003;66:140–7.PubMed
18.
Dequanter D, Shahla M, Paulus P, Aubert C, Lothaire P. Transarterial endovascular treatment in the management of life-threatening carotid blowout syndrome in head and neck cancer patients: review of the literature. J Mal Vasc. 2013;38(6):341–4.CrossRefPubMed
19.
Liang NL, Guedes BD, Duvvuri U, et al. Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer. J Vasc Surg. 2016;63(6):1525–30.CrossRefPubMed
Metadata
Title
Endovascular Management of Patients with Head and Neck Cancers Presenting with Acute Hemorrhage: A Single-Center Retrospective Study
Authors
P. P. Vilas Boas
L. H. de Castro-Afonso
L. M. Monsignore
G. S. Nakiri
F. V. de Mello-Filho
D. G. Abud
Publication date
01-04-2017
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 4/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-016-1550-8

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