Flow-diverter in radiation-induced skull base carotid blowout syndrome: do not write it off!

Flow-diverter in radiation-induced skull base carotid blowout syndrome: do not write it off!

Neurosurg Rev. 2017 Jul 16;:

Authors: Anil G, Zhang J, Ong YK, Hui F

Abstract
Post-radiotherapy carotid blowout syndrome (CBS) of the skull base is a rare but often catastrophic complication of head and neck malignancies. The existing literature on the treatment of this condition with flow-diverting devices (FDD) is extremely limited and disappointing. We present a case of impending CBS in a patient previously irradiated for nasopharyngeal cancer that was successfully treated with use of multiple FDDs, adjunctive endonasal packing and delayed reinforcement with pedicled naso-septal flap, yielding an excellent outcome at 14-months follow-up. Notwithstanding the discouraging results in literature, our anecdotal experience suggests that endovascular reconstruction using FDD could be an option with long-term viability in post-radiotherapy CBS involving the skull base when reinforced with a vascularised naso-septal flap.

PMID: 28712070 [PubMed - as supplied by publisher]

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