• Cardiovasc Intervent Radiol · Feb 2011

    Case Reports

    Delayed development of brain abscesses following stent-graft placement in a head and neck cancer patient presenting with carotid blowout syndrome.

    • Yaseen Oweis, Joseph J Gemmete, Neeraj Chaudhary, Aditya Pandey, and Sameer Ansari.
    • University of Michigan Medical School, Ann Arbor, MI 48109-0030, USA.
    • Cardiovasc Intervent Radiol. 2011 Feb 1; 34 Suppl 2: S31-5.

    AbstractWe describe the delayed development of intracranial abscesses following emergent treatment with a covered stent-graft for carotid blowout syndrome (CBS) in a patient with head and neck cancer. The patient presented with hemoptysis and frank arterial bleeding through the tracheostomy site. A self-expandable stent-graft was deployed across a small pseudoaneurysm arising from the right common carotid artery (RCCA) and resulted in immediate hemostasis. Three months later, the patient suffered a recurrent hemorrhage. CT of the neck demonstrated periluminal fluid around the caudal aspect of the stent-graft with intraluminal thrombus and a small pseudoaneurysm. Subsequently, the patient underwent a balloon test occlusion study and endovascular sacrifice of the RCCA and right internal carotid artery. MRI of the brain demonstrated at least four ring-enhancing lesions within the right cerebral hemisphere consistent with intracranial abscesses that resolved with broad-spectrum antibiotic coverage.

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