Post neck radiation cancer carotid pseudoaneurysm blowouts with Viabahn stent placement

Carotid Blowout Syndrome (CBS) is a critical and often fatal complication associated with head and neck malignancies. CBS is characterized by three stages: threatened, impending, and acute rupture/hemorrhage. The condition is notably linked with a history of radiotherapy for head and neck cancers, with an incidence of approximately 3-4% among those who have received such treatment. Historically, surgical management of CBS has involved open surgical ligation. However, advancements in endovascular techniques, including endovascular destructive procedures (e.g., coil embolization) and reconstructive procedures (e.g., carotid artery stenting), have become increasingly prevalent. This report presents two cases where a self-expandable PTFE-coated nitinol stent with a heparin coating (Viabahn; Gore and Associates) was utilized in the treatment of CBS.