Journal of Korean Neurosurgical Society

  • 제41권5호
  • /
  • Pages.327-329
  • /
  • 2007
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Stent-assisted Angioplasty for Symptomatic Radiation-induced Carotid Stenosis

  • Kwon, Yoon-Kwang (Department of Neurosurgery, Keimyung University School of Medicine) ;
  • Kim, Eal-Maan (Department of Neurosurgery, Keimyung University School of Medicine) ;
  • Lee, Chang-Young (Department of Neurosurgery, Keimyung University School of Medicine)
  • 발행 : 2007.05.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

A 44-year-old woman presented with recurrent, transient episodes of left-side hemiparesis. She had received a radiation dose of 6120 cGy to her cervical region for parotid gland carcinoma 13 years previously. Cerebral angiography revealed a long, irregular tight stenosis involving the right extracranial internal carotid artery [ICA] and common carotid artery [CCA], measuring approximately 90% at the most severe narrowing according to North American Symptomatic Carotid Endarterectomy Trial criteria. Endovascular stent placement resulted in restoration of the carotid lumen to about 80% of its original diameter. She showed no further ischemic events during the follow-up period of 48 months. Our clinical and angiographic findings suggest that carotid stenting is considered a safe and effective treatment option in patients with radiation-induced carotid stenosis.

키워드

참고문헌

  1. Atkinson JLD, Sundt TM, Dale AJD, Cascino TL, Nichols DA : Radiation-associated atheromatous disease of the cervical carotid artery : a report of seven cases and review of the literature. Neurosurgery 24 : 171-178, 1989 https://doi.org/10.1227/00006123-198902000-00004
  2. Cheng SWK, Wu LL, Ting AC, Lau H, Lam LK, Wei WI : Irradiation induced extracranial carotid stenosis in patients with head and neck malignancies. Am J Surg 18 : 323-328, 1999
  3. Cohen JE, Rajz G, Lylyk P, Ben-Hur T, Gomori JM, Umansky F : Protected stent-assisted angioplsty in radiation-induced carotid artery stenosis. Neurol Res 27(Suppl 1) : S69-72, 2005 https://doi.org/10.1179/016164105X25333
  4. Conomy JP, Kellermeyer R : Delayed cerebrovascular consequences of therapeutic radiation : a clinicopathologic study of a stroke associated with radiation-related cervical carotid arteriopathy. Cancer 36 : 1702- 1708, 1975 https://doi.org/10.1002/1097-0142(197511)36:5<1702::AID-CNCR2820360525>3.0.CO;2-V
  5. Ecker RD, Donovan MT, Hopkins LN : Endovascular management of carotid artery disease after radiation therapy and radical neck dissection. Neurosurg Focus 18 : E8, 2005
  6. Fajardo LF, Lee A : Rupture of major vessels after radiation. Cancer 36 : 904-913, 1995
  7. Houdart E, Mounayer C, Chapot R, Saint-Maurice JP, Merland JJ : Carotid stenting for radiation-induced stenoses : a report of 7 cases. Stroke 32 : 118-121, 2001 https://doi.org/10.1161/01.STR.32.1.118
  8. Koebbe CJ, Liebman K, Veznedaroglu E, Rosenwasser R : The role of carotid angioplasty and stenting in carotid revascularization. Neurol Res 27 (Suppl 1) : 53-58, 2005
  9. Loftus CM, Biller J, Hart MN, Cornell SH, Hiratzka LF : Management of radiation-induced accelerated carotid atherosclerosis. Arch Neurol 44 : 711-714, 1987 https://doi.org/10.1001/archneur.1987.00520190023011
  10. McCready GE, Hyde GL, Bivins BA, Mattingly SS, Griffen WD : Radiation-induced arterial injuries. Surgery 93 : 306-312, 1983
  11. Murros KE, Toole JF : The effect of radiation on carotid arteries. A review article. Arch Neurol 46 : 449-455, 1989 https://doi.org/10.1001/archneur.1989.00520400109029
  12. Rockman CB, Riles TS, Fisher FS, Adelman MA, Lamparello PJ : The surgical management of carotid artery stenosis in patients with previous neck irradiation. Am J Surg 172 : 191-195, 1996 https://doi.org/10.1016/S0002-9610(96)00150-X
  13. Silverberg GD, Britt RH, Goffinet DR : Radiation - induced carotid artery disease. Cancer 41 : 130-137, 1978 https://doi.org/10.1002/1097-0142(197801)41:1<130::AID-CNCR2820410121>3.0.CO;2-X
  14. Ting AC, Cheng SW, Yeung KM, Cheng PW, Lui WM, Ho P et al : Carotid stenting for radiation-induced extracranial carotid artery occlusive disease : efficacy and midterm outcomes. J Endovasc Ther 11 : 53-59, 2004 https://doi.org/10.1583/1545-1550(2004)011<0053:CSFREC>2.0.CO;2