Management of Arterial Blowout in Oncology Patients: An Endovascular Perspective

Arterial blowout syndrome (ABS) is a life-threatening complication encountered in patients with advanced malignancies, particularly following surgery, radiation therapy, infection, or recurrent tumor infiltration, and is more common in the head and neck region. The carotid artery is most commonly involved; however, branches of the external carotid artery and subclavian artery may also be affected. Prompt diagnosis and urgent endovascular intervention are critical for hemorrhage control and patient stabilization. We present a case series of four oncological patients who developed acute arterial blowouts. All patients were successfully managed with endovascular techniques, including covered stent placement or embolization. This series highlights the feasibility, effectiveness, and life-saving role of minimally invasive endovascular management in ABS, particularly when with head and neck cancers.