title: Outcome of carotid artery stenting for radiation-induced stenosis.
abstract: OBJECTIVE
  Patients who have been irradiated at the neck have an increased risk of symptomatic stenosis of the carotid artery during follow-up. Carotid angioplasty and stenting (CAS) can be a preferable alternative treatment to carotid endarterectomy, which is associated with increased operative risks in these patients.
  
  
  METHODS
  We performed a prospective cohort study of 24 previously irradiated patients who underwent CAS for symptomatic carotid stenosis. We assessed periprocedural and nonprocedural events including transient ischemic attack (TIA), nondisabling stroke, disabling stoke, and death. Patency rates were evaluated on duplex ultrasound scans. Restenosis was defined as a stenosis of >50% at the stent location.
  
  
  RESULTS
  Periprocedural TIA rate was 8%, and periprocedural stroke (nondisabling) occurred in 4% of patients. After a mean follow-up of 3.3 years (range, 0.3-11.0 years), only one ipsilateral incident event (TIA) had occurred (4%). In 12% of patients, a contralateral incident event was present: one TIA (4%) and two strokes (12%, two disabling strokes). Restenosis was apparent in 17%, 33%, and 42% at 3, 12, and 24 months, respectively, although none of the patients with restenosed vessels became symptomatic. The length of the irradiation to CAS interval proved the only significant risk factor for restenosis.
  
  
  CONCLUSIONS
  The results of CAS for radiation-induced carotid stenosis are favorable in terms of recurrence of cerebrovascular events at the CAS site.
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands. L.Dorresteijn@mst.nl
authors.forename: Lucille D A
authors.initials: LD
authors.lastname: Dorresteijn
authors.forename: Oscar J M
authors.initials: OJ
authors.lastname: Vogels
authors.forename: Frank-Erik
authors.initials: FE
authors.lastname: de Leeuw
authors.forename: Jan-Albert
authors.initials: JA
authors.lastname: Vos
authors.forename: Marleen H
authors.initials: MH
authors.lastname: Christiaans
authors.forename: Rob G A
authors.initials: RG
authors.lastname: Ackerstaff
authors.forename: Arnoud C
authors.initials: AC
authors.lastname: Kappelle
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D016893:Carotid Stenosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male; D011446:Prospective Studies; D011832:Radiation Injuries / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000209:etiology*