Document Detail


Outcome of carotid artery stenting for radiation-induced stenosis.
MedLine Citation:
PMID:  20116932     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Lucille D A Dorresteijn; Oscar J M Vogels; Frank-Erik de Leeuw; Jan-Albert Vos; Marleen H Christiaans; Rob G A Ackerstaff; Arnoud C Kappelle
Publication Detail:
Type:  Journal Article     Date:  2010-01-29
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  77     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1386-90     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands. L.Dorresteijn@mst.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon
Carotid Stenosis / mortality,  therapy*
Female
Follow-Up Studies
Head and Neck Neoplasms / radiotherapy*
Humans
Ischemic Attack, Transient / etiology*
Male
Prospective Studies
Radiation Injuries / mortality,  therapy*
Recurrence
Stents* / adverse effects
Stroke / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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