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The Clinical Outcome of Carotid Blowout Syndrome Showing Non-bleeding Angiography

  • Clinical Investigation
  • Embolization (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Objective

Patient with carotid blowout syndrome (CBS) may demonstrated non-bleeding digital subtraction angiography (DSA) without identifying pseudoaneurysm or contrast extravasation. Our objective is to evaluate the clinical outcomes for this specific subset of patients.

Materials and Methods

A retrospective observational study was conducted on 172 CBS patients who received DSA for evaluation of transarterial embolization (TAE) between 2005 and 2022, of whom 19 patients had non-bleeding DSA and did not undergo TAE.

Results

The age (55.2 ± 7.3 vs. 54.8 ± 11.1), male sex (17/19 vs. 135/153), tumor size (5.6 ± 2.4 vs. 5.2 ± 2.2), cancer locations were similar (P > 0.05) between both groups; except for there were more pseudoaneurysm/active bleeding (85.6% vs. 0%) and less vascular irregularity (14.4% vs. 94.7%) in the TAE group (P < 0.001). In the multivariable Cox regression model adjusting for age, sex, and tumor size, non-bleeding DSA group was independently associated with recurrent bleeding compared to TAE group (adjusted hazard ratio = 3.5, 95% confidence interval: 1.9–6.4, P < 0.001). Furthermore, the presence of vascular irregularity was associated with segmental recurrent bleeding (adjusted HR = 8.0, 95% CI 2.7–23.3, P < 0.001).

Conclusion

Patient showing non-bleeding DSA thus not having TAE had higher risk of recurrent bleeding, compared to patient who received TAE.

Level of Evidence Level 4, Case Series.

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Funding

This work was supported by grants from the National Taiwan University Hospital (Lee BC, 111-X0002 & 112-S0198) and National Science and Technology Council of Taiwan (111-2314-B-002-250-MY2).

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Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan

    Bo-Ching Lee

  2. Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan

    Bo-Ching Lee, Yen-Heng Lin, Ya-Fang Chen & Chung-Wei Lee

  3. Department of Medical Imaging, Yun-Lin Branch, National Taiwan University Hospital, No.579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County, 640, Taiwan

    Bo-Ching Lee & Hong-Jen Hsieh

  4. College of Medicine, National Taiwan University, Taipei, Taiwan

    Yung-Ching Hu

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Correspondence to Hong-Jen Hsieh.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This study was approved by the IRB of our hospital and informed consent was waived.

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This study will present in part at the 72nd Annual Meeting of the Taiwan Radiological Society.

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Lee, BC., Hu, YC., Lin, YH. et al. The Clinical Outcome of Carotid Blowout Syndrome Showing Non-bleeding Angiography. Cardiovasc Intervent Radiol (2024). https://doi.org/10.1007/s00270-024-03723-y

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  • DOI: https://doi.org/10.1007/s00270-024-03723-y

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