One stage carotid artery resection: reconstruction in radiated head and neck carcinoma.
OBJECTIVE
Management of the carotid artery involved with metastatic squamous cell carcinoma continues to be a topic of much discussion. Early reports, for the most part, focused on the sequel of ligation and the development of various tests to predict patient tolerance for the procedure. More recent alternatives have described resection reconstruction in multistage procedures. By using immediate reconstruction with autogenous arterial grafting, carotid artery resection can be accomplished in patients with radiation failure in a single stage. This technique can be used without the addition of myocutaneous flaps, controlled fistulas, or intracranial surgery advocated for usage with alternative techniques.


METHODS
Immediate reconstruction after resection of the carotid artery with superficial femoral arterial graft is described.


RESULTS
In a series of 18 high-risk patients with radiation failure, the artery was successfully resected and reconstructed in 1 stage without any neurologic or vascular complications. The technique has been associated with prolonged survival in selected patients.


CONCLUSIONS
Carotid artery resection and immediate reconstruction can be performed in high-risk radiation failure patients with acceptable complications, and is associated with prolonged survival in selected cases.
Jacobs
J R
JR
Wayne State University School of Medicine, Department of Otolaryngology Head and Neck Surgery, Detroit, MI 48201, USA.
Korkmaz
H
H
Marks
S C
SC
Kline
R
R
Berguer
R
R
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D002339:Carotid Arteries / Q000528:radiation effects / Q000601:surgery*; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D011878:Radiotherapy / Q000009:adverse effects; D016879:Salvage Therapy / Q000379:methods; D013524:Surgical Flaps; D013997:Time Factors