Endovascular management of hemorrhage in patients with head and neck cancer

David D. Morrissey, Peter Andersen, Gary Nesbit, Stanley L. Barnwell, Edwin C. Everts, James Cohen

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective: To present selective endovascular embolization as a therapeutic alternative to surgical ligation in the management of hemorrhage in patients with head and neck squamous cell carcinoma. Design: Retrospective chart review of patients with head and neck cancer and significant hemorrhage who were treated with selective endovascular embolization. Setting: A university medical center. Patients: A total of 12 patients, aged 26 to 72 years, with 13 episodes of hemorrhage were treated at Oregon Health Sciences University, Portland, between November 1991 and January 1996. Intervention: All patients underwent angiography with selective endovascular embolization at the interventional radiology suite using a combination of endovascular balloons, platinum coils, and microparticles. Outcome Measures: All charts were reviewed for diagnosis, treatment, factors that may have contributed to hemorrhage, bleeding site, therapeutic measures, control of hemorrhage, postembolization course, complications, and number of hospital days. Results: The cause of the bleeding was tumor in 5 patients, pharyngocutaneous fistula in 4 patients, radiation necrosis in 3 patients, and postoperative complication in 1 patient. Bleeding arose from the common carotid artery in 4 patients, external carotid artery and its branches in 8 patients, and internal jugular vein in 1 patient. Hemorrhage was successfully controlled in all patients; a permanent left-sided hemiplegia and facial weakness developed in 1 patient. There were no recurrences of hemorrhage. All patients were discharged from the hospital. Conclusion: Angiography with selective embolization is a safe and effective alternative to surgical ligation for control of hemorrhage in patients with squamous cell carcinoma of the head and neck.

Original languageEnglish (US)
Pages (from-to)15-19
Number of pages5
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume123
Issue number1
StatePublished - 1997

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Head and Neck Neoplasms
Hemorrhage
Ligation
Angiography
External Carotid Artery
Interventional Radiology
Hemiplegia
Common Carotid Artery
Jugular Veins
Platinum
Fistula

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Endovascular management of hemorrhage in patients with head and neck cancer. / Morrissey, David D.; Andersen, Peter; Nesbit, Gary; Barnwell, Stanley L.; Everts, Edwin C.; Cohen, James.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 123, No. 1, 1997, p. 15-19.

Research output: Contribution to journalArticle

Morrissey, David D. ; Andersen, Peter ; Nesbit, Gary ; Barnwell, Stanley L. ; Everts, Edwin C. ; Cohen, James. / Endovascular management of hemorrhage in patients with head and neck cancer. In: Archives of Otolaryngology - Head and Neck Surgery. 1997 ; Vol. 123, No. 1. pp. 15-19.
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