[MO-84] Presentation Awards
A case of treatment using VIABAHN against common carotid artery injury.
【Objectives】
VIABAHN is used for not only the purpose of improving the blood flow of symptomatic peripheral artery disease patients, but also iatrogenic or traumatic vascular injury. We report a case that treatment using VIABAHN was very effective against common carotid artery injury.
【Case】
A case is 75 years old male, he received total thyroidectomy against the poorly differentiated cancer in September 2017. But the cancer reappeared in March 2018, invasion into the trachea, cricoid cartilage and the esophagus was observed, re-surgery was performed, the invasion range was wide, and the carotid artery also had infiltration, so only tracheotomy was given. The drug therapy with Lenvatinib began after operation, but as a result of tumor collapse due to the therapeutic effect, tracheostomy and esophagus fistula were formed, which became a source of infection to surrounding tissues. In addition, the tumor around the artery collapsed, causing the weakening of the arterial wall. As a result, the common carotid artery ruptured, resulting in shock due to massive bleeding. For lifesaving purposes, EVT for the right common carotid artery was enforced. Even during therapy, when pressure on the bleeding point was not continued, it was in a state of causing a sudden decrease in blood pressure due to bleeding, but after the indwelling of VIABAHN 8/100 mm, 8/50 mm, there was no bleeding and hemodynamics was stable. The postoperative course is good and we are currently continuing treatment for thyroid cancer.
【Conclusion】
We could survive the patient by using VIABAHN against common carotid artery injury due to malignant tumor.
VIABAHN is used for not only the purpose of improving the blood flow of symptomatic peripheral artery disease patients, but also iatrogenic or traumatic vascular injury. We report a case that treatment using VIABAHN was very effective against common carotid artery injury.
【Case】
A case is 75 years old male, he received total thyroidectomy against the poorly differentiated cancer in September 2017. But the cancer reappeared in March 2018, invasion into the trachea, cricoid cartilage and the esophagus was observed, re-surgery was performed, the invasion range was wide, and the carotid artery also had infiltration, so only tracheotomy was given. The drug therapy with Lenvatinib began after operation, but as a result of tumor collapse due to the therapeutic effect, tracheostomy and esophagus fistula were formed, which became a source of infection to surrounding tissues. In addition, the tumor around the artery collapsed, causing the weakening of the arterial wall. As a result, the common carotid artery ruptured, resulting in shock due to massive bleeding. For lifesaving purposes, EVT for the right common carotid artery was enforced. Even during therapy, when pressure on the bleeding point was not continued, it was in a state of causing a sudden decrease in blood pressure due to bleeding, but after the indwelling of VIABAHN 8/100 mm, 8/50 mm, there was no bleeding and hemodynamics was stable. The postoperative course is good and we are currently continuing treatment for thyroid cancer.
【Conclusion】
We could survive the patient by using VIABAHN against common carotid artery injury due to malignant tumor.