Radiotherapy-induced common carotid pseudoaneurysm presenting with initially occult upper airway hemorrhage and successfully treated by endovascular stent graft

Damien J. Ellens, Michael C. Hurley, Daniel Surdel, Ali Shaibani, Harold Pelzer, Bernard R. Bendok*

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)195-198
Number of pages4
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume31
Issue number3
DOIs
StatePublished - May 1 2010

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ASJC Scopus subject areas

  • Otorhinolaryngology

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