A Clinical Series in Patients with Naso-Pharyngeal Cancer and Their Outcomes with Stent Graft Treatment for Sentinel Bleeding to Prevent Frank Carotid Rupture.

BACKGROUND: The purpose of this study was to evaluate the safety and effectiveness of heparin-bonded VIABAHN stent graft for carotid rupture in patients with nasopharyngeal carcinoma (NPC). METHODS: A total of 1,596 patients with NPC were enrolled. Fifteen patients (8 male and 7 female), who developed carotid artery rupture (CAR) after radiotherapy between January 2016 and June 2019, were retrospectively analyzed. Complications and mortality were assessed at 12 months postoperatively. RESULTS: The incidence of carotid burst syndrome in the NPC cohort was 0.94%. The distribution of site of arterial rupture was as follows: common carotid artery (4 cases), C1 segment of internal carotid artery (8 cases), and C2 segment of internal carotid artery (3 cases). All patients successfully underwent emergency deployment of the heparin-bonded VIABAHN to seal off the ruptured carotid artery. The survival rate as of 12-month follow-up was 80.0%. Three patients died of short-term rebleeding, lung infection, and tumor progression. No stent-related complications occurred in our cohort. CONCLUSIONS: Heparin-bonded VIABAHN-covered stents may be a safe and effective treatment option for carotid rupture in patients with NPC.