Carotid artery stenting for radiation-induced carotid stenosis

Yusuke Egashira, Tetsu Satow, Kosuke Masuda, Masakazu Okawa, Hiroyuki Ohnishi, Takahito Okazaki, Jun C. Takahashi, Ken Ichi Murao, Koji Iihara, Susumu Miyamoto

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Abstract

Purpose and Methods: To evaluate the outcome and lesion characteristics in patients with radiation induced carotid stenoses (RI-CS) treated by carotid artery stenting (CAS), a total of five patients with RI-CS (six lesions) were retrospectively analyzed. Results: Four lesions had their most stenotic site at the common carotid artery (CCA). All cases had contralateral carotid or vertebral artery stenosis (>50%). All patients had risk factors of atherosclerosis and all lesions contained unstable plaques at the stenotic site. A total of seven procedures were carried out and procedural success was obtained in all cases. Asymptomatic embolic infarctions associated with procedure were observed in four cases by diffusion-weighted MR imaging. In-stent thrombi were observed in two cases, one of which developed a neurological symptom three days after the procedure. Conclusion: CAS is a technically successful intervention for RI-CS. Care should be taken according to the characteristics of the plaque, which usually is vulnerable and long. Appropriate choice of a protection method could help in the reduction of unfavorable embolic complications and close postoperative follow up is mandatory.

Original languageEnglish
Pages (from-to)913-920
Number of pages8
JournalNeurological Surgery
Volume38
Issue number10
Publication statusPublished - Oct 1 2010

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Egashira, Y., Satow, T., Masuda, K., Okawa, M., Ohnishi, H., Okazaki, T., ... Miyamoto, S. (2010). Carotid artery stenting for radiation-induced carotid stenosis. Neurological Surgery, 38(10), 913-920.