Key result
Protective stenting of the distal internal carotid artery was similarly effective but safer than endovascular occlusion for preventing carotid blowout syndrome in NPC patients (P=0.04).
Why the study?
Carotid blowout syndrome frequently occurs at the distal internal carotid artery in nasopharyngeal carcinoma patients, and remedial treatments carry a high risk of neurologic complications.
Does protective stent insertion at the distal-ICA improve safety and efficacy compared to endovascular coil occlusion in NPC patients at high risk of CBS?
Case-Control (n=28)
No
Does protective stent insertion at the distal-ICA improve safety and efficacy compared to endovascular coil occlusion in NPC patients at high risk of CBS?
p-value: p=0.04
Protective stenting of the distal-ICA appears to be a safer alternative to endovascular occlusion for preventing carotid blowout syndrome in patients with nasopharyngeal carcinoma.
Protective stenting may reduce periprocedural stroke risk versus occlusion for CBS in NPC; hypothesis-generating pending randomized data.
Background: Carotid blowout syndrome (CBS) frequently occurs at the distal internal carotid artery (distal-ICA) in patients with nasopharyngeal carcinoma (NPC), and remedial treatments run a high risk for neurologic complications. A case-control study was conducted to evaluate the safety and efficacy of protective stent insertion at the distal-ICA to prevent CBS in NPC patients, with a comparison to endovascular coil occlusion. Methods: A total of 28 consecutive NPC patients at high risk of CBS from June 2019 to December 2021 in Shanghai Sixth People's Hospital (a tertiary institution) were retrospectively included and divided into a stent protection group and occlusion group. Technique feasibility, treatment outcomes and neurological deficiency were compared between the two groups by two-sample test. Kaplan-Meier analysis compared patients' survival rates at mid-term follow-up. Results: 15.8 months, P=0.04). Conclusions: Protective stenting the distal-ICA was similarly effective in preventing CBS in NPC patients but was safer than endovascular occlusion of ICA.
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Tang et al. (2024) conducted a case-control in Nasopharyngeal carcinoma at high risk of carotid blowout syndrome (n=28). Protective stent insertion at the distal internal carotid artery vs. Endovascular coil occlusion was evaluated on Technique feasibility, treatment outcomes and neurological deficiency (p=0.04). Protective stenting of the distal internal carotid artery was similarly effective but safer than endovascular occlusion for preventing carotid blowout syndrome in NPC patients (P=0.04).
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