Outcome of carotid angioplasty and stenting for radiationassociated stenosis

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


Background and purpose: In light of their high surgical risk, carotid angioplasty and stent placement may be preferred in patients with radiation-associated carotid stenosis. The purpose of this study was to determine the procedural complication rate, patency, and clinical outcomes after carotid angioplasty and stent placement in this small group of high-risk patients.

Methods: Sixteen patients (mean age, 65 years; 5 women and 11 men) who received radiation therapy for head and/or neck malignancy subsequently developed carotid stenosis (mean, 84%; range, 70%-99%) in a total of 19 carotid arteries, which were treated with angioplasty and stent placement. The patients were followed for a mean time of 28 months (range, 5-78 months) with periodic Doppler studies, angiography, CT angiography, or clinically.

Results: In the total 19 stented carotid arteries, 23 procedures were performed (22 stent placement procedures and one repeat angioplasty). The procedural stroke rate was 1/23 (4%). The procedural transient ischemic attack rate was 0/23 (0%). There was one other observed complication: a puncture site hematoma. The 30-day postprocedure complication rate was 0/23 (0%); no neurologic symptoms were reported. Fifteen of the 19 vessels (79%) developed no new stenosis throughout the follow-up period. Two of 19 (11%) vessels had repeat angioplasty and stent placement; 1/19 (5%) had a repeat angioplasty. One restented vessel has remained patent for 50 months. Another restented vessel required a third stent placement 17 months after the second. Two of 19 (11%) vessels occluded per Doppler examination 14 and 22 months postprocedure.

Conclusion: Angioplasty and stent placement have low rates of complications and restenosis in the treatment of radiation-associated carotid occlusive disease.

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.

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.