Carotid Endarterectomy for Radiation-induced Carotid Stenosis

Abstract

This study aimed to elucidate the surgery-related treatment outcomes in patients who underwent carotid endarterectomy (CEA) for radiation-induced carotid stenosis (RI-CS). We retrospectively reviewed the records of 11 patients who underwent CEA for RI-CS between July 2004 and April 2013. The end-points included ipsilateral and contralateral stroke, mortality, myocardial infarction, cranial nerve injury (CNI), wound complications, ipsilateral ischemic lesions on diffusion-weighted magnetic resonance imaging within 48 hours, and restenosis. Among the early outcomes (≤30 days), CNI occurred in one patient. Among the late outcomes (>30 days), restenosis occurred in one patient, who did not require revascularization. The only ischemic event that occurred in one patient was thrombosis of the carotid artery on the contralateral side. There were no other complications. RI-CS is often accompanied by the formation of vulnerable plaques. CEA can prevent undesirable outcomes in such cases. In addition, appropriate patient selection could avoid CNI and wound complications in patients with RI-CS. Simultaneous hybrid revascularization by CEA and carotid artery stenting may also be useful for RI-CS.