Cases of diagnostics and endovascular treatment of radiation-induced internal carotid artery stenosis
DOI:
https://doi.org/10.24144/2415-8127.2018.58.5-12Keywords:
radiation-induced stenosis, radiotherapy, internal carotid artery, carotid stenting.Abstract
The aim of the work was to diagnose and select the optimal surgical treatment of radiation-induced stenosis of internal carotid arteries. Stenting of internal carotid artery was performed in two patients, who underwent radiotherapy for nasopharyngeal and laryngeal carcinomas. The results of 3 months follow-up had shown satisfactory neurological status. The neck arteries Doppler ultrasonography follow up in 6 and 12 months and, if necessary, cerebral angiography were recommended. An analysis of the endovascular surgical treatment results in case of the neck vessels radiation induced damage showed that the surgical tactics was justified and could be used as a method to treat this pathology.
References
Steele SR, Martin MJ, Mullenix PS, Crawford JV, Cuadrado DS, Andersen CA. Focused high-risk population screening for carotid arterial stenosis after radiation therapy for head and neck cancer. Am J Surg. 2004;5:594– 598. [PubMed].
Lam WW, Leung SF, So NM, Wong KS, Liu KH, Ku PK, Yuen HY, Metreweli C. Incidence of carotid stenosis in nasopharyngeal carcinoma patients after radiotherapy. Cancer. 2001;92:2357–2363. [PubMed].
Cheng SW, Ting AC, Lam LK, Wei WI. Carotid stenosis after radiotherapy for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2000;126:517–521. [PubMed].
Huang TL, Hsu HC, Chen HC, Lin HC, Chien CY, Fang FM, Huang CC, Chang HW, Chang WN, Huang CR, et al. Long-term effects on carotid intima-media thickness after radiotherapy in patients with nasopharyngeal carcinoma. Radiat Oncol. 2013;8:261. [PMC free article] [PubMed].
Dorresteijn LD, Kappelle AC, Boogerd W, Klokman WJ, Balm AJ, Keus RB, van Leeuwen FE, Bartelink H. Increased risk of ischemic stroke after radiotherapy on the neck in patients younger than 60 years. J Clin Oncol. 2002;20:282–288. [PubMed].
Smith GL, Smith BD, Buchholz TA, Giordano SH, Garden AS, Woodward WA, Krumholz HM, Weber RS, Ang KK, Rosenthal DI. Cerebrovascular disease risk in older head and neck cancer patients after radiotherapy. J Clin Oncol. 2008;26:5119–5125. [PubMed].
Murros KE, Toole JF. The effect of radiation on carotid arteries. A review article. Arch Neurol. 1989;46:449– 455. [PubMed].
Konings AW, Hardonk MJ, Wieringa RA, Lamberts HB. Initial events in radiation-induced atheromatosis I. Activation of lysosomal enzymes. Strahlentherapie. 1975;150:444–448. [PubMed].
Sugihara T, Hattori Y, Yamamoto Y, Qi F, Ichikawa R, Sato A, Liu MY, Abe K, Kanno M. Preferential impairment of nitric oxide-mediated endothelium-dependent relaxation in human cervical arteries after irradiation. Circulation. 1999;100:635–641. [PubMed].
