Acute Internal Carotid Artery Rupture (Carotid Blow Out): Emergency Treatment by Endovascular Coil Occlusion of Carotid Artery

Abstract

We report a rare case of acute internal carotid artery rupture following radical resection and radiotherapy for an ulcerative carcinoma of the tongue. The patient presented with acute bleeding from the post operative site two weeks following radiotherapy. A surgical pressure bandage was placed and angiography was performed. There was a massive bleed from the ICA once the dressing was removed. The common carotid and internal carotid arteries were occluded with platinum 0.035 coils placed rapidly and the bleeding stopped. As the collateral circulation was good, the patient had no neurological deficits. There are only a few case reports of carotid blow out (carotid rupture) in literature. Most of the cases are treated by either surgery or endovascular detachable balloons. To our knowledge, this is the first case where microcoils were used to treat carotid blow out.