Resection of the extra cranial carotid artery in head and neck cancer.

Carotid artery resection and reconstruction by unreversed autogenous saphenous vein grafting was undertaken in six patients undergoing extensive resection for malignancy over a four-year period. There were two deaths within 30 days of operation: one from secondary hemorrhage and one from bronchopneumonia. One patient died at six months and one at three months from recurrence, one died at 12 months from recurrence and one died free of disease at 10 months from aspiration. Vascular complications in three patients included a single TIA at 14 days, graft thrombosis with hemiplegia and a secondary hemorrhage from the graft requiring graft ligature with a subsequent normal neurological status. Malignant involvement of the extracranial carotid artery is associated with poor survival. Treatment by carotid artery resection and grafting should be considered in such cases, particularly where the pharynx or oral cavity are not entered.