Outcomes of carotid stenting in patients with previous neck radiation.

Academic Article

Abstract

  • OBJECTIVES: Our aim was to report outcomes of percutaneous stenting of carotid stenosis in patients with previous neck radiation. BACKGROUND: Post-irradiation carotid disease is often extensive and involves atypical areas. Data regarding outcomes of stenting of these lesions are scarce. METHODS: We retrospectively reviewed medical records at our institution from January 1998 through May 2010 to determine baseline characteristics, procedural details, and follow-up data of patients who underwent stenting of radiation-associated carotid stenosis. RESULTS: Our study included 70 patients who underwent a total of 83 procedures. Of these, 47 patients were male (67%), mean age was 66.3 ± 10.6 years. Mean follow-up was 47.5 months (range from 1 to 155 months). All patients had a history of radiotherapy to the neck area, with laryngeal cancer being the most common reason. Furthermore, 41 patients (58.5%) had previous neck surgery due to malignancies. An embolic protection device was used in 61 (73%) procedures. During the follow-up, 5 (6%) ipsilateral events among a total of 10 (12.0%) ischemic events were observed. There was 1 intraprocedural stroke (1.2%), but there were no other ischemic event at 30 days and 1-year post procedure. Mortality was 4.8% during the first 30 days, 8.6% during the first year and 60% at the end of the study. Restenosis was seen in 2 (2.4%) patients at 1 year and in total nine patients (10.8 %) with long-term follow-up. CONCLUSIONS: Carotid stenting is a safe and durable treatment option for patients with severe carotid stenosis and neck radiation.
  • Keywords

  • carotid artery stenosis, radiation associated, stenting, Aged, Angioplasty, Balloon, Brain Ischemia, Carotid Stenosis, Embolic Protection Devices, Female, Head and Neck Neoplasms, Hospitals, High-Volume, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Ohio, Radiation Injuries, Radiotherapy, Recurrence, Retrospective Studies, Risk Factors, Severity of Illness Index, Stents, Stroke, Tertiary Care Centers, Time Factors, Treatment Outcome
  • Digital Object Identifier (doi)

    Authorlist

  • Cam A; Shishehbor MH; Bajaj NS; Ozkan A; Bajzer CT; Kapadia SR
  • Start Page

  • 689
  • End Page

  • 695
  • Volume

  • 82
  • Issue

  • 5