Advertisement

Imaging Characteristics and Reintervention in Patients after Radiation Induced Carotid Artery Stenting

      Background

      To evaluate and describe the radiographic imaging findings in a series of patients who underwent reintervention after radiation induced carotid artery stenting (RICAS).

      Methods

      A retrospective review of patients with prior RICAS and subsequent reintervention.

      Results

      We describe 10 patients including 8 male and 2 female patients with 12 reinterventions due to prior diagnosed radiation-induced carotid artery stenosis and subsequent stenting during the period 2000–2019. The rate of reintervention was found to be 10%. The pattern of stenosis is unique to this patient population including specifically long-segment stenosis, proximal and distal to the stent location, which tends not to occur in the atherosclerotic patient population.

      Conclusions

      Careful surveillance after RICAS is necessary to assess for the risk and the unusual pattern of stenosis to offer reintervention in this high-risk patient population.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Annals of Vascular Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Erben Y.
        • Franco-Mesa C.
        • Miller D.
        • et al.
        Higher risk for reintervention in patients after stenting for radiation-induced internal carotid artery stenosis: a single-center analysis and systematic review.
        Ann Vasc Surg. 2021; 73: 1-14
        • Nasr B.
        • Crespy V.
        • Penasse E.
        • et al.
        Association Universitaire Pour la Recherche en Chirurgie (AURC) Group..
        J Endovasc Ther. 2022; (15266028211068757)https://doi.org/10.1177/15266028211068757
        • AbuRahma A.F.
        • Abu-Halimah S.
        • Bensenhaver J.
        • et al.
        Optimal carotid duplex velocity criteria for defining the severity of carotid in-stent restenosis.
        J Vasc Surg. 2008; 48: 589-594
        • Shichita T.
        • Ogata T.
        • Yasaka M.
        • et al.
        Angiographic characteristics of radiation-induced carotid arterial stenosis.
        Angiology. 2009; 60: 276-282
        • Zahn R.
        • Ischinger T.
        • Zeymer U.
        • et al.
        Carotid artery interventions for restenosis after prior stenting: is it different from interventions of de novo lesions? Results from the carotid artery stent (CAS)--registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausarzte (ALKK).
        Clin Res Cardiol. 2010; 99: 809-815
        • Al-Mubarak N.
        • Roubin G.S.
        • Iyer S.S.
        • et al.
        Carotid stenting for severe radiation-induced extracranial carotid artery occlusive disease.
        J Endovasc Ther. 2000; 7: 36-40
        • Jones R.W.
        • Conant M.
        • Tanious A.
        • et al.
        Single center outcomes of carotid artery stenting in veterans with prior head and neck cancer.
        Ann Vasc Surg. 2021; 70: 230-236
        • Sano N.
        • Satow T.
        • Maruyama D.
        • et al.
        Relationship between histologic features and outcomes of carotid revascularization for radiation-induced stenosis.
        J Vasc Surg. 2015; 62: 370-377.e1
        • Fokkema M.
        • den Hartog A.G.
        • van Lammeren G.W.
        • et al.
        Radiation-induced carotid stenotic lesions have a more stable phenotype than de novo atherosclerotic plaques.
        Eur J Vasc Endovasc Surg. 2012; 43: 643-648
        • Bianchini Massoni C.
        • Gargiulo M.
        • Pini R.
        • et al.
        Radiation-induced carotid stenosis: perioperative and late complications of surgical and endovascular treatment.
        J Cardiovasc Surg (Torino). 2017; 58: 680-688
        • Minc S.D.
        • Thibault D.
        • Marone L.
        Outcomes of carotid artery stenting in patients with radiation arteritis compared with those with atherosclerotic disease.
        J Vasc Surg. 2022; 75: 1286-1292
        • Cheng S.W.
        • Ting A.C.
        • Wu L.L.
        Ultrasonic analysis of plaque characteristics and intimal-medial thickness in radiation-induced atherosclerotic carotid arteries.
        Eur J Vasc Endovasc Surg. 2002; 24: 499-504
        • Sabetai M.M.
        • Tegos T.J.
        • Nicolaides A.N.
        • et al.
        Hemispheric symptoms and carotid plaque echomorphology.
        J Vasc Surg. 2000; 31: 39-49