Egashira Yusuke, Satow Tetsu, Masuda Kosuke, Okawa Masakazu, Ohnishi Hiroyuki, Okazaki Takahito, Takahashi Jun C, Murao Ken-Ichi, Iihara Koji, Miyamoto Susumu
Department of Neurosurgery, National Cerebral and Cardiovascular Center, Gifu University, Gifu-city, Gifu, Japan.
No Shinkei Geka. 2010 Oct;38(10):913-20.
To evaluate the outcome and lesion characteristics in patients with radiation induced carotid stenoses (RI-CS) treated by carotid artery stenting (CAS), a total of five patients with RI-CS (six lesions) were retrospectively analyzed.
Four lesions had their most stenotic site at the common carotid artery (CCA). All cases had contralateral carotid or vertebral artery stenosis (>50%). All patients had risk factors of atherosclerosis and all lesions contained unstable plaques at the stenotic site. A total of seven procedures were carried out and procedural success was obtained in all cases. Asymptomatic embolic infarctions associated with procedure were observed in four cases by diffusion-weighted MR imaging. In-stent thrombi were observed in two cases, one of which developed a neurological symptom three days after the procedure.
CAS is a technically successful intervention for RI-CS. Care should be taken according to the characteristics of the plaque, which usually is vulnerable and long. Appropriate choice of a protection method could help in the reduction of unfavorable embolic complications and close postoperative follow up is mandatory.
