Acute common carotid artery blowout despite endovascular treatment of pseudoaneurysm

Carotid blowouts are a low-incidence complication of head and neck tumors. We present the case of a 56-year-old man with squamous cell carcinoma of the supraglottic larynx causing acute hemoptysis. Pseudoaneurysm was discovered on the left distal carotid artery and subsequently, a stent was placed. Despite treatment, re-hemorrhage occurred distal to the covered stent leading to irreversible brain damage and death. We provide striking images of active extravasation and propose liberal deployment of long stent constructs in treating this pathology. It may be beneficial for the interventionalist to place a stent covering the area affected by the tumor rather than the area of the pseudoaneurysm.