Predisposing factors, management, and prognostic evaluation of acute carotid blowout syndrome Hsueh-Ju Lu, MD, Kuo-Wei Chen, MD, Ming-Huang Chen, MD,

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Predisposing factors, management, and prognostic evaluation of acute carotid blowout syndrome Hsueh-Ju Lu, MD, Kuo-Wei Chen, MD, Ming-Huang Chen, MD, Pen-Yuan Chu, MD, Shyh-Kuan Tai, MD, Ling-Wei Wang, MD, Peter Mu-Hsin Chang, MD, Muh-Hwa Yang, MD, PhD Journal of Vascular Surgery Volume 58, Issue 5, Pages 1226-1235 (November 2013) DOI: 10.1016/j.jvs.2013.04.056 Copyright © 2013 Terms and Conditions

Fig 1 Computed tomography (CT) and angiography findings of acute carotid blowout syndrome (ACBS). In (A) and (B), a 54-year-old man who was diagnosed with hypopharyngeal cancer and under palliative chemotherapy treatment presented with acute left common carotid artery (CCA) CBS. A CT scan revealed necrotic soft tissue involving the left CCA (thick black arrow). The angiography results revealed acute extravasation from a pseudoaneurysm of the left middle CCA (thick white arrow). In (C) and (D), a 67-year-old man with glottic cancer was evaluated for poor wound healing following neck dissection. A deep ulcerative wound was found in the right anterior neck. The lesion was close to the right CCA (thin black arrow). Acute rupture in the right CCA was found on angiography (thin white arrow). Journal of Vascular Surgery 2013 58, 1226-1235DOI: (10.1016/j.jvs.2013.04.056) Copyright © 2013 Terms and Conditions

Fig 2 Neutrophil-to-lymphocyte (N/L) ratio before and after acute carotid blowout syndrome (ACBS) in survivor or nonsurvivor patients. The N/L ratios were significantly higher 24 hours after ACBS onset relative to those at initial onset (P = .012 and .019 in both groups, respectively). The N/L ratio did not differ between both groups at initial onset (P = .527), but was significantly much higher in the group with nonsurvivors than in the group with survivors after 24 hours (P = .007). Journal of Vascular Surgery 2013 58, 1226-1235DOI: (10.1016/j.jvs.2013.04.056) Copyright © 2013 Terms and Conditions

Fig 3 Overall survival of survivors and nonsurvivors. The median overall length of survival of survivors and nonsurvivors was 12.1 (range, 3.7-118.7; 95% confidence interval [CI], 4.33-54.87) and 11.9 (range, 0.7-53.5; 95% CI, 5.78-25.69) months, respectively (P = .092). Journal of Vascular Surgery 2013 58, 1226-1235DOI: (10.1016/j.jvs.2013.04.056) Copyright © 2013 Terms and Conditions