Preoperative Protective Endovascular Covered Stent Placement Followed by Surgery for Management of the Cervical Common and Internal Carotid Arteries with Tumor Encasement.
ObjectiveThe objective of this study was to report the outcomes on a preliminary cohort of patients with tumor encasement of either, or both, the cervical internal carotid artery (ICA) and common carotid artery (CCA) following preoperative covered stent placement and surgical resection.SettingThis study was set at the University of Florida College of Medicine, Jacksonville, FL.ParticipantsSubjects who received preoperative stenting of the cervical ICA/CCA before surgical resection of head and neck tumors between April 1, 2015, and July 31, 2015 were participated.Main Outcome MeasuresThe outcomes assessed were resectability of tumors after stenting, histopathological assessment of specimen margins, complications associated with stenting.ResultsFive subjects received preoperative covered stent placement of the ICA/CCA before surgical resection. The mean age was 65.2 years. Median follow-up was 3.5 months. Excision of the adventitia from the stent was performed in all subjects. No intraoperative complications occurred. One vascular-related complication occurred in one subject who suffered occlusion of the stent, sustaining a ministroke. No involvement of tumor at the deep margin (inner surface of adventitia) of the resection was seen in any subjects.ConclusionsPreoperative covered stent placement of the cervical ICA/CCA in the management of subjects with head and neck tumors who display encasement on preoperative imaging may represent a safe and effective treatment.
Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine, Jacksonville, Florida, United States.
Michael R
MR
Markiewicz
Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine, Jacksonville, Florida, United States.
Phillip
P
Pirgousis
Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, United States.
Curtis
C
Bryant
Division of Vascular and Interventional Radiology, Department of Radiology, University of Florida College of Medicine, Jacksonville, Florida, United States.
James C
JC
Cunningham
Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, United States.
Roi
R
Dagan
Division of Neuroradiology, Department of Radiology, University of Florida College of Medicine, Jacksonville, Florida, United States.
Sukhwinder J
SJ
Sandhu
Division of Vascular and Interventional Radiology, Department of Radiology, University of Florida College of Medicine, Jacksonville, Florida, United States.
Daniel A
DA
Siragusa
Department of Pathology and Laboratory Medicine, University of Florida College of Medicine, Jacksonville, Florida, United States.
Arun
A
Gopinath
Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine, Jacksonville, Florida, United States; Division of Surgical Oncology, University of Florida College of Medicine, Jacksonville, Florida, United States.
Rui
R
Fernandes
common carotid artery; head and neck neoplasms; internal carotid artery; squamous cell carcinoma