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Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()

OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who under...

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Autores principales: Trojanowski, Piotr, Sojka, Michał, Trojanowska, Agnieszka, Wolski, Andrzej, Roman, Tomasz, Jargiello, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Neoplasia Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542749/
https://www.ncbi.nlm.nih.gov/pubmed/31146165
http://dx.doi.org/10.1016/j.tranon.2019.05.001
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author Trojanowski, Piotr
Sojka, Michał
Trojanowska, Agnieszka
Wolski, Andrzej
Roman, Tomasz
Jargiello, Tomasz
author_facet Trojanowski, Piotr
Sojka, Michał
Trojanowska, Agnieszka
Wolski, Andrzej
Roman, Tomasz
Jargiello, Tomasz
author_sort Trojanowski, Piotr
collection PubMed
description OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who underwent surgery and subsequently cervical radiotherapy (RT) for HNSCC, focusing on radiation-induced vascular disease in neck arteries—from the latency period to the occurrence of neurological events—and the endovascular treatment of the internal carotid artery (ICA) and/or of common carotid artery (CCA) stenoses. The vascular lesions were diagnosed with Doppler ultrasonography and selective digital angiography. Patients with >70% stenoses of ICA and/or CCA were scheduled for carotid artery stenting (CAS). They were followed-up with neurological examinations and Doppler ultrasonography at 6, 12, and 24 months after stenting. RESULTS: Radiation-induced vascular diseases occurred in the ICA in 22 patients (85%), CCA in 15 (58%), and in ECA in 15 (58%). The stents were implanted in 25 ICA and 17 CCA. Thirteen patients (50%) had one stent, eight (30%) had two stents, four (15%) had three stents, and one patient had five stents. Overall, 46 stents were implanted. Technical success was achieved in all patients. No cerebrovascular events occurred in the 24-months follow-up. CONCLUSION: RT in patients with HNSCC holds a significant risk factor of developing carotid artery stenosis and cerebrovascular events. Carotid stenting is preferable mode of treatment for radiation-induced stenosis. A screening program with doppler ultrasonography enables pre-stroke detection of carotid stenosis.
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spelling pubmed-65427492019-06-03 Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() Trojanowski, Piotr Sojka, Michał Trojanowska, Agnieszka Wolski, Andrzej Roman, Tomasz Jargiello, Tomasz Transl Oncol Original article OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who underwent surgery and subsequently cervical radiotherapy (RT) for HNSCC, focusing on radiation-induced vascular disease in neck arteries—from the latency period to the occurrence of neurological events—and the endovascular treatment of the internal carotid artery (ICA) and/or of common carotid artery (CCA) stenoses. The vascular lesions were diagnosed with Doppler ultrasonography and selective digital angiography. Patients with >70% stenoses of ICA and/or CCA were scheduled for carotid artery stenting (CAS). They were followed-up with neurological examinations and Doppler ultrasonography at 6, 12, and 24 months after stenting. RESULTS: Radiation-induced vascular diseases occurred in the ICA in 22 patients (85%), CCA in 15 (58%), and in ECA in 15 (58%). The stents were implanted in 25 ICA and 17 CCA. Thirteen patients (50%) had one stent, eight (30%) had two stents, four (15%) had three stents, and one patient had five stents. Overall, 46 stents were implanted. Technical success was achieved in all patients. No cerebrovascular events occurred in the 24-months follow-up. CONCLUSION: RT in patients with HNSCC holds a significant risk factor of developing carotid artery stenosis and cerebrovascular events. Carotid stenting is preferable mode of treatment for radiation-induced stenosis. A screening program with doppler ultrasonography enables pre-stroke detection of carotid stenosis. Neoplasia Press 2019-05-27 /pmc/articles/PMC6542749/ /pubmed/31146165 http://dx.doi.org/10.1016/j.tranon.2019.05.001 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original article
Trojanowski, Piotr
Sojka, Michał
Trojanowska, Agnieszka
Wolski, Andrzej
Roman, Tomasz
Jargiello, Tomasz
Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
title Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
title_full Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
title_fullStr Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
title_full_unstemmed Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
title_short Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
title_sort management of radiation induced carotid stenosis in head and neck cancer()
topic Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542749/
https://www.ncbi.nlm.nih.gov/pubmed/31146165
http://dx.doi.org/10.1016/j.tranon.2019.05.001
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