Carotid stenting for radiation-induced stenoses - A report of 7 cases

Background and Purpose-Radiation-induced stenoses of the carotid artery are associated with fibrosis of the arterial layers and tissue planes that renders their surgical treatment difficult. We present our clinical experience in carotid angioplasty stenting (CAS) of patients harboring such stenoses. Methods-Seven patients underwent transfemoral CAS of 10 radiation-induced stenoses located on either the common or the internal carotid artery. Six patients presented neurological symptoms. Four patients had undergone previous radical neck dissection, and 3 had permanent tracheostomies. Stenoses were primarily covered with a self-expandable stent before carotid dilation. Results-All interventions were successful, with residual stenoses <20%. No permanent complication occurred. The mean follow-up was 8 months. Patients were symptom free at the last clinical examination, and Doppler control showed no evidence of restenosis. Conclusions-Carotid stenting appears very attractive for such "hostile neck" patients and seems a safe and efficient treatment for radiation-induced stenoses.