title: Carotid artery stenting for stenosis following revascularization or cervical irradiation.
abstract: OBJECTIVE
  To assess the safety and efficacy of carotid artery stenting (CAS) for stenosis following revascularization or cervical irradiation.
  
  
  METHODS
  Twenty-two CAS procedures performed on 21 patients (20 men; mean age 69.3 years, range 58-87) from June 1997 to June 2000 were retrospectively reviewed. There were 5 radiation-induced carotid stenoses in 4 patients and 17 postsurgical restenoses. The mean interval between carotid revascularization and CAS was 48.1 months (range 6-264), while the elapsed time from irradiation to CAS was always >8 years (range 8-28). Seven patients screened during this period were excluded from CAS because of a duplex-defined >50% hypoechoic lesion and/or angiographic documentation of an irregular ulcerated stenosis.
  
  
  RESULTS
  Four Palmaz and 16 Wallstents were successfully deployed in 20 arteries; 1 access failure prompted conversion to surgery and a stent delivery failure resulted in 1 patient receiving balloon dilation only (technical success 91%). No complications were encountered in the periprocedural period, and no neurological events were observed during a mean follow-up of 16.6 months (range 3-36). One patient died at 20 months from an unrelated cause. One (4.8%) restenosis was detected after 1 year in the patient who did not receive a stent.
  
  
  CONCLUSIONS
  CAS is a safe alternative to conventional surgery in patients with carotid artery stenosis following surgical revascularization or cervical irradiation provided preoperative testing excludes stenoses at risk for embolism.
authors.affiliation: Service de Chirurgie Vasculaire et Thoracique, Hĵpital Arnaud de Villeneuve, Montpellier, France. pierrealric@hotmail.com
authors.forename: Pierre
authors.initials: P
authors.lastname: Alric
authors.forename: Pascal
authors.initials: P
authors.lastname: Branchereau
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Berthet
authors.forename: Henri
authors.initials: H
authors.lastname: Mary
authors.forename: Charles
authors.initials: C
authors.lastname: Marty-Ané
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods* / Q000401:mortality; D002339:Carotid Arteries / Q000528:radiation effects*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology