Carotid stenting for radiation-induced extracranial carotid artery occlusive disease: efficacy and midterm outcomes

Author(s): Ting AC, Cheng SW, Yeung KM, Cheng PW, Lui WM, et al.


Purpose: To investigate the immediate and midterm results of carotid stenting for severe radiation-induced extracranial carotid artery disease.

Methods: Between April 1998 and May 2002, 16 patients (15 men; mean age 64 +/- 8 years, range 48-72) presented with 18 severe radiation-induced carotid stenoses in the internal carotid artery (n=3), common carotid artery (n=7), and both vessels (n=8). Thirteen (76%) patients were symptomatic; the mean degree of carotid stenosis was 85% +/- 10% (range 70%-95%). An independent neurological specialist assessed perioperative neurological complications before and after treatment. The patients were followed prospectively for at least 12 months by clinical examination and serial duplex ultrasound scanning. Restenosis was defined as a diameter reduction >50%.

Results: Of 18 stent procedures attempted (2 staged), 1 was abandoned owing to failure to pass the guidewire across a tight lesion (94% technical success by intent to treat). In the 17 successfully completed procedures, 17 Wallstents and 4 SMART stents were deployed with satisfactory anatomical results. One postoperative stroke occurred as a result of thromboembolism to the ipsilateral middle cerebral artery and led to hospital death (5.9% combined stroke and death rate). One transient ischemic attack occurred (11.6% neurological event rate). With a median 30-month follow-up (range 5-55), 3 (17.6%) recurrent stenoses (>50%) were detected on duplex scan; 1 repeat angioplasty was performed. No new neurological event has been detected.

Conclusions: Carotid stenting may be performed in patients with irradiation-induced carotid stenosis with acceptable risks and midterm durability.

Similar Articles

Incidence of carotid stenosis in nasopharyngeal carcinoma patients after radiotherapy

Author(s): Lam WW, Leung SF, So NM, Wong KS, Liu KH, et al.

Mcmurtrey, Carotidartery disease following external cervical irradiation

Author(s): Elerding SC, Fernandez RN, Grotta JC, Lindberg RD, Causay LC, et al.

Carotid stenosis after radiotherapy for nasopharyngeal carcinoma, Arch

Author(s): Cheng SWK, Ting ACW, Lam LKL, Wei WI

Angioplasty for Symptomatic Radiation?induced Extracranial Carotid Artery

Author(s): Ahuja A, Blatt GL, Guterman LR, Hopkins LN

Bilateral Carotid Stenting for Radiation-Induced Arterial Stenosis

Author(s): Ohta H, Sakai N, Nagata I, Sakai H, Higashi T, et al.

Carotid stenting for severe radiation-induced extracranial carotid artery occlusive disease

Author(s): Mubarak NA, Roubin GS, Iyer SS, Gomez CR, Liu MW, et al.

Protected stent-assisted angioplasty in radiation-induced carotid artery stenosis

Author(s): Cohen JE, Rajz G, Lylyk P, Hur TB, Gomori JM, et al.

Outcome of carotid angioplasty and stenting for radiationassociated stenosis

Author(s): Kim PH, Kadkhodayan Y, Derdeyn CP, Moran CJ

A Management ofradiation-induced occlusive arterial disease: a reassessment

Author(s): Mellière D, Becquemin JP, Berrahal , Desgranges P, Cavillon

Adjuvant radiotherapy and chemotherapy in node—positive premenopausal women with breast cancer

Author(s): Ragaz J, Jackson SM, Le N, Plenderleith IH, Spinelli JJ, et al.

Sustained inflammation due to nuclear factor-kappa B activation in irradiated human arteries

Author(s): Halle M, Gabrielsen A, Paulsson-Berne G, Gahm C, Agardh HE, et al.

Clinical features of radiation-induced carotid atherosclerosis

Author(s): Gujral DM, Shah BN, Chahal NS, Senior R, Harrington KJ, et al.