Rupture of radiation-induced internal carotid artery pseudoaneurysm in a patient with nasopharyngeal carcinoma--spontaneous occlusion of carotid artery due to long-term embolizing performance.

Abstract

Rupture of internal carotid artery (ICA) pseudoaneurysm is a lethal complication in patients with nasopharyngeal carcinoma (NPC). Angiography is the best diagnostic and treatment method. The aim of embolization is to block the pseudoaneurysm; but sometimes, total occlusion of great vessels is ineludible. We describe a case of NPC post-radiation therapy and with ruptured pseudoaneurysm treated by angio-embolization. The patient had received embolization with numerous tools such as stent grafts, balloons, and bare stents with or without filter protection. After failing to pass through the narrow lumen by embolizing tools, the right ICA finally occluded spontaneously by self-thrombosis. Although the angio-embolization is a good method to resolve the problems of ruptured pseudoaneurysm, there is still high mortality and morbidity. Being aware of the clinical presentations and the changes of images may alert us to predict the happening earlier.