Endovascular Management of Massive Bleeding from Laryngeal Tumor

Laryngeal tumors are commonly seen in Ear, Nose and Throat (ENT) department. Hemoptysis is one of the common presentations of these tumors. Carotid blowout syndrome (CBS) due to bleeding from the pseudo-aneurysm (PA) is a dreaded complication of head and neck tumors. Sometimes it can be massive and difficult to control and maybe fatal. Surgical bypass or ligation of external carotid was the only option available, but it had high mortality and morbidity associated with it. Endovascular management has given a new hope for these patients, in the form of covered stent implantation. These endovascular stents works by reconstructing the arterial wall, maintain its patency and decrease the ischemic complication rate which was higher with surgical option due to vessel deconstruction strategies. Recurrent bleeding can occur due to infection of stent which is a fearful complication but it occurs late and its reported rate in the previous studies ranges from 33-86%. We present a case of such tumor complicated with massive bleeding, which was managed by an endovascular approach. This is probably the first case where massive bleeding from the laryngeal tumor was managed with endovascular stent and embolization of blood vessels supplying the larynx.