Outcome of carotid artery stenting for radiation-induced stenosis

L. D. Dorresteijn, O. J. Vogels, F E. de Leeuw, J. A. Vos, M.H. Christiaans, R.G. Ackerstaff, A.C. Kappelle

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: Patients who have been irradiated at the neck have an increased risk of symptomatic stenosis of the carotid artery during follow-up. Carotid angioplasty and stenting (CAS) can be a preferable alternative treatment to carotid endarterectomy, which is associated with increased operative risks in these patients. METHODS AND MATERIALS: We performed a prospective cohort study of 24 previously irradiated patients who underwent CAS for symptomatic carotid stenosis. We assessed periprocedural and nonprocedural events including transient ischemic attack (TIA), nondisabling stroke, disabling stoke, and death. Patency rates were evaluated on duplex ultrasound scans. Restenosis was defined as a stenosis of >50% at the stent location. RESULTS: Periprocedural TIA rate was 8%, and periprocedural stroke (nondisabling) occurred in 4% of patients. After a mean follow-up of 3.3 years (range, 0.3-11.0 years), only one ipsilateral incident event (TIA) had occurred (4%). In 12% of patients, a contralateral incident event was present: one TIA (4%) and two strokes (12%, two disabling strokes). Restenosis was apparent in 17%, 33%, and 42% at 3, 12, and 24 months, respectively, although none of the patients with restenosed vessels became symptomatic. The length of the irradiation to CAS interval proved the only significant risk factor for restenosis. CONCLUSIONS: The results of CAS for radiation-induced carotid stenosis are favorable in terms of recurrence of cerebrovascular events at the CAS site.
Original languageEnglish
Pages (from-to)1386-1390
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume77
Issue number5
DOIs
Publication statusPublished - 1 Aug 2010

Keywords

  • Carotid angioplasty and stenting
  • Stroke
  • Radiotherapy
  • Head and neck cancer
  • Carotid artery stenosis
  • NECK IRRADIATION
  • ISCHEMIC-STROKE
  • ANGIOPLASTY
  • RADIOTHERAPY
  • RISK
  • ENDARTERECTOMY
  • BIFURCATION
  • DISEASE
  • HEAD

Cite this

Dorresteijn, L. D., Vogels, O. J., de Leeuw, F. E., Vos, J. A., Christiaans, M. H., Ackerstaff, R. G., & Kappelle, A. C. (2010). Outcome of carotid artery stenting for radiation-induced stenosis. International Journal of Radiation Oncology Biology Physics, 77(5), 1386-1390. https://doi.org/10.1016/j.ijrobp.2009.06.045