Carotid artery replacement in conjunction with resection of squamous cell carcinoma of the neck: preliminary results.
Squamous cell carcinoma can invade the carotid artery. The treatment options then include irradiation, "palliative peeling" of tumor from the artery, and carotid resection with ligation or in-line grafting. Twelve patients with invasion of the carotid artery by cancer had en bloc resection of the artery and tumor. Reconstruction after in-line carotid artery grafting with autogenous vein was completed with a myocutaneous flap. No neurologic events occurred perioperatively or during the follow-up period of 3 to 50 months. Computed tomography and arteriography were unreliable in predicting tumor involvement of the carotid artery. Three patients died during the study--two of unrelated causes, and one of metastases. None of the patients showed evidence of local recurrence from 3 to 50 months. In two of four wound infections the carotid artery graft was exposed. This was successfully treated by a myocutaneous flap. The mean survival for the group was 18 months. Resection and in-line bypass grafting of the carotid artery invaded by cancer can safely be performed in irradiated and potentially infected fields.
Reilly
M K
MK
Department of Otolaryngology, Vanderbilt University School of Medicine, Nashville, TN 37212.
Perry
M O
MO
Netterville
J L
JL
Meacham
P W
PW
D000368:Aged; D001807:Blood Vessel Prosthesis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012501:Saphenous Vein / Q000637:transplantation; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed