title: Outcomes of carotid stenting in patients with previous neck radiation.
abstract: OBJECTIVE
  Our aim was to report outcomes of percutaneous stenting of carotid stenosis in patients with previous neck radiation.
  
  
  BACKGROUND
  Post-irradiation carotid disease is often extensive and involves atypical areas. Data regarding outcomes of stenting of these lesions are scarce.
  
  
  METHODS
  We retrospectively reviewed medical records at our institution from January 1998 through May 2010 to determine baseline characteristics, procedural details, and follow-up data of patients who underwent stenting of radiation-associated carotid stenosis.
  
  
  RESULTS
  Our study included 70 patients who underwent a total of 83 procedures. Of these, 47 patients were male (67%), mean age was 66.3 ± 10.6 years. Mean follow-up was 47.5 months (range from 1 to 155 months). All patients had a history of radiotherapy to the neck area, with laryngeal cancer being the most common reason. Furthermore, 41 patients (58.5%) had previous neck surgery due to malignancies. An embolic protection device was used in 61 (73%) procedures. During the follow-up, 5 (6%) ipsilateral events among a total of 10 (12.0%) ischemic events were observed. There was 1 intraprocedural stroke (1.2%), but there were no other ischemic event at 30 days and 1-year post procedure. Mortality was 4.8% during the first 30 days, 8.6% during the first year and 60% at the end of the study. Restenosis was seen in 2 (2.4%) patients at 1 year and in total nine patients (10.8 %) with long-term follow-up.
  
  
  CONCLUSIONS
  Carotid stenting is a safe and durable treatment option for patients with severe carotid stenosis and neck radiation.
authors.affiliation: Department of Internal Medicine, Cleveland, Ohio.
authors.forename: Akin
authors.initials: A
authors.lastname: Cam
authors.forename: Mehdi H
authors.initials: MH
authors.lastname: Shishehbor
authors.forename: Navkaranbir S
authors.initials: NS
authors.lastname: Bajaj
authors.forename: Alper
authors.initials: A
authors.lastname: Ozkan
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Bajzer
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002545:Brain Ischemia / Q000209:etiology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D057505:Embolic Protection Devices; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D061847:Hospitals, High-Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009820:Ohio; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000209:etiology; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome