[Bilateral carotid stenting for radiation-induced arterial stenosis].
We report a case of bilateral radiation-induced internal carotid artery (ICA) stenosis treated with stenting. A 67-year-old man experienced transient left hemiparesis several times, and it was diagnosed as a bilateral ICA stenosis by magnetic resonance angiogram (MRA) and cervical ultrasound sonogram (US). Ten years before, the patient had received radiation therapy (66 Gy) and radical resection for a squamous cell carcinoma (SCC) in the right infrapharyngeal space. A cerebral angiogram showed bilateral severe ICA stenosis (right; 90%, left; 99%). We diagnosed this as radiation-induced ICA stenosis, and performed carotid angioplasty with a self-expanding stent. The post-operative course was uneventful and the patient was discharged without neurological deficits. Carotid endarterectomy (CEA) is difficult in the case of carotid artery stenosis due to radiation-induced arterial injury. Carotid stenting may be an alternative treatment for such a patient.
Ohta
H
H
Department of Neurosurgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-0873, Japan.
Sakai
N
N
Nagata
I
I
Sakai
H
H
Higashi
T
T
Takahashi
J
J
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000528:radiation effects*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects*; D015607:Stents