Comparison of Prophylactic Endovascular Treatments for Threatened or Impending Internal/Common Carotid Artery Blowout Syndrome.
Journal
American journal of neuroradiology
Journal Volume
46
Journal Issue
8
Start Page
1632
End Page
1639
ISSN
1936-959X
Date Issued
2025-08-01
Author(s)
Abstract
BACKGROUND AND PURPOSE: The outcomes of prophylactic endovascular interventions for patients facing threatened or impending carotid blowout syndrome (CBS) involving the ICA/common carotid artery (CCA) have not been extensively elucidated. We aimed to delineate the specific treatment outcomes for this group of patients. MATERIALS AND METHODS: We retrospectively enrolled 109 patients with threatened or impending CBS of the ICA/CCA between 2006 and 2023. Patients were categorized into group 1 (no intervention for ICA/CCA, n¼43), group 2 (ICA/CCA embolization, n¼36), or group 3 (ICA/CCA stent placement, n¼30). ANOVA and Cox regression analyses were employed to evaluate basic characteristics and the rates of recurrent bleeding, overall survival, and major complications. RESULTS: Age (56.8 6 8.7 versus 54.3 6 11.6 versus 56.6 6 9.2), male sex (39/43 versus 33/36 versus 26/30), tumor size, and type of blowout were similar (P . .05) among groups. Tumor location (P, .001) and presence of air-containing necrosis on CT/MRI before transarterial embolization (P ¼ .001) varied between groups. Cox regression analysis adjusted for age and sex revealed group 2 had a lower risk of recurrent bleeding than group 1 (adjusted hazard ratio [HR], 0.22; 95% CI: 0.10–0.47; P, .001) and group 3 (0.41; 95% CI: 0.17–0.96; P ¼ .042), but a higher risk of acute stroke (P ¼ .016). Group 2 had higher overall survival than groups 1 and 3 (0.55; 95% CI: 0.31–0.96; P ¼ .036). CONCLUSIONS: In threatened or impending CBS of the ICA/CCA, prophylactic embolization was associated with a lower risk of recurrent bleeding but a higher risk of acute stroke compared with ICA/CCA stent placement or no intervention. © 2025 American Society of Neuroradiology.
SDGs
Publisher
American Society of Neuroradiology
Type
journal article