Carotid blowouts may occur secondary to recurrent tumours, infection, or severe radiation damage, and has a high mortality rate. I learned about this condition while in the clinics as a medical student and apparently, insertion of endovascular grafts (similar to how EVAR can be used for AAA) are not a first-line treatment, even though it makes sense theoretically. The literature offers contradictory conclusions regarding its efficacy. Is there something I am missing?