Journal of Vascular Surgery
Volume 50, Issue 6 , Pages 1308-1313 , December 2009

Safety and efficacy of carotid angioplasty and stenting for radiation-associated carotid artery stenosis

The following study was presented at the Twenty-Second Annual Meeting of the Eastern Vascular Society, Boston, Mass, Sep 18-20, 2008.

  • Mikel Sadek, MD

      Affiliations

    • New York University Medical Center, New York, NY
    • ,
  • Neal S. Cayne, MD

      Affiliations

    • New York University Medical Center, New York, NY
    • ,
  • Hyun J. Shin, MD

      Affiliations

    • Mount Sinai School of Medicine, New York, NY
    • ,
  • Irene C. Turnbull, MD

      Affiliations

    • Mount Sinai School of Medicine, New York, NY
    • ,
  • Michael L. Marin, MD

      Affiliations

    • Mount Sinai School of Medicine, New York, NY
    • ,
  • Peter L. Faries, MD

      Affiliations

    • Mount Sinai School of Medicine, New York, NY
    • Corresponding Author InformationReprint requests: Peter L. Faries, MD, FACS, Chief, Division of Vascular Surgery, Mount Sinai School of Medicine, 5 East 98th St., Box 1273, New York, NY 10029-6574

Received 24 April 2009 ,Accepted 2 July 2009.

References 

  1. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis (North American Symptomatic Carotid Endarterectomy Trial Collaborators). N Engl J Med. 1991;325:445–453
  2. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis (European Carotid Surgery Trialists' Collaborative Group). Lancet. 1991;337:1235–1243
  3. Endarterectomy for asymptomatic carotid artery stenosis (Executive Committee for the Asymptomatic Carotid Atherosclerosis Study). JAMA. 1995;273:1421–1428
  4. Hobson RW, Weiss DG, Fields WS, Goldstone J, Moore WS, Towne JB, et al. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis (The Veterans Affairs Cooperative Study Group). N Engl J Med. 1993;328:221–227
  5. Mayberg MR, Wilson SE, Yatsu F, Weiss DG, Messina L, Hershey LA, et al. Carotid endarterectomy and prevention of cerebral ischemia in symptomatic carotid stenosis (Veterans Affairs Cooperative Studies Program 309 Trialist Group). JAMA. 1991;266:3289–3294
  6. CaRESS Steering Committee. Carotid Revascularization Using Endarterectomy or Stenting Systems (CaRESS) phase I clinical trial: 1-year results. J Vasc Surg. 2005;42:213–219
  7. Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, et al. Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–1501
  8. Henry M, Polydorou A, Klonaris C, Henry I, Polydorou AD, Hugel M. Carotid angioplasty and stenting under protection (State of the art). Minerva Cardioangiol. 2007;55:19–56
  9. Wondergem J, Wedekind LE, Bart CI, Chin A, van der Laarse A, Beekhuizen H. Irradiation of mechanically-injured human arterial endothelial cells leads to increased gene expression and secretion of inflammatory and growth promoting cytokines. Atherosclerosis. 2004;175:59–67
  10. Hoving S, Heeneman S, Gijbels MJ, te Poele JA, Russell NS, Daemen MJ, et al. Single-dose and fractionated irradiation promote initiation and progression of atherosclerosis and induce an inflammatory plaque phenotype in ApoE(−/−) mice. Int J Radiat Oncol Biol Phys. 2008;71:848–857
  11. Bilora F, Pietrogrande F, Petrobelli F, Polato G, Pomerri F, Muzzio PC. Is radiation a risk factor for atherosclerosis? (An echo-color Doppler study on Hodgkin and non-Hodgkin patients). Tumori. 2007;93:232;author reply 232
  12. Apter S, Shemesh J, Raanani P, Portnoy O, Thaler M, Zissin R, et al. Cardiovascular calcifications after radiation therapy for Hodgkin lymphoma: computed tomography detection and clinical correlation. Coron Artery Dis. 2006;17:145–151
  13. Patel DA, Kochanski J, Suen AW, Fajardo LF, Hancock SL, Knox SJ. Clinical manifestations of noncoronary atherosclerotic vascular disease after moderate dose irradiation. Cancer. 2006;106:718–725
  14. DeRubertis BG, Chaer RA, Gordon R, Bell H, Hynecek RL, Pieracci FM, et al. Determining the quantity and character of carotid artery embolic debris by electron microscopy and energy dispersive spectroscopy. J Vasc Surg. 2007;45:716–724discussion 724-5. Epub 2007 Feb 15
  15. Mas JL, Chatellier G, Beyssen B EVA-3S Investigators. Carotid angioplasty and stenting with and without cerebral protection: clinical alert from the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3S) trial. Stroke. 2004;35:e18–e20
  16. Wennberg DE, Lucas FL, Birkmeyer JD, Bredenberg CE, Fisher ES. Variation in carotid endarterectomy mortality in the Medicare population: trial hospitals, volume, and patient characteristics. JAMA. 1998;279:1278–1281
  17. Goldstein LB. New data about stenting versus endarterectomy for symptomatic carotid artery stenosis. Curr Treat Options Cardiovasc Med. 2009;11:232–240
  18. Ricci MA, Waters MA, Peate D. The role of noninvasive studies in the diagnosis and management of cerebrovascular disease. In:  Rutherford RB editors. Vascular Surgery. 6th ed.. Philadelphia, Pa: WB Saunders Co; 2005;p. 1957–1973
  19. Stewart FA, Heeneman S, Te Poele J, Kruse J, Russell NS, Gijbels M, et al. Ionizing radiation accelerates the development of atherosclerotic lesions in ApoE−/− mice and predisposes to an inflammatory plaque phenotype prone to hemorrhage. Am J Pathol. 2006;168:649–658
  20. Katayama I, Hotokezaka Y, Matsuyama T, Sumi T, Nakamura T. Ionizing radiation induces macrophage foam cell formation and aggregation through JNK-dependent activation of CD36 scavenger receptors. Int J Radiat Oncol Biol Phys. 2008;70:835–846
  21. Younis GA, Gupta K, Mortazavi A, Strickman NE, Krajcer Z, Perin E, et al. Predictors of carotid stent restenosis. Catheter Cardiovasc Interv. 2007;69:673–682
  22. Protack CD, Bakken AM, Saad WE, Illig KA, Waldman DL, Davies MG. Radiation arteritis: a contraindication to carotid stenting?. J Vasc Surg. 2007;45:110–117
  23. Kang JH, Kwon SU, Kim JS. Radiation-induced angiopathy in acute stroke patients. J Stroke Cerebrovasc Dis. 2002;11:315–319
  24. Miller SH, Rudolph R. Healing in the irradiated wound. Clin Plast Surg. 1990;17:503–508
  25. Cremonesi A, Manetti R, Setacci F, Setacci C, Castriota F. Protected carotid stenting: clinical advantages and complications of embolic protection devices in 442 consecutive patients. Stroke. 2003;34:1936–1941Epub 2003 Jul 3
  26. Hammer FD, Lacroix V, Duprez T, Grandin C, Verhelst R, Peeters A, et al. Cerebral microembolization after protected carotid artery stenting in surgical high-risk patients: results of a 2-year prospective study. J Vasc Surg. 2005;42:847–853discussion 853
  27. Flach HZ, Ouhlous M, Hendriks JM, Van Sambeek MR, Veenland JF, Koudstaal PJ, et al. Cerebral ischemia after carotid intervention. J Endovasc Ther. 2004;11:251–257
  28. Romero JR. Prevention of ischemic stroke: overview of traditional risk factors. Curr Drug Targets. 2007;8:794–801
  29. Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695–1709
  30. Theiss W, Hermanek P, Mathias K, Brückmann H, Dembski J, Hoffmann FJ, et al. German Society of Angiology/Vascular Medicine; German Society of Radiology Predictors of death and stroke after carotid angioplasty and stenting: a subgroup analysis of the Pro-CAS data. Stroke. 2008;39:2325–2330Epub 2008 Jun 26
  31. Park B, Aiello F, Dahn MS, Menzoian JO, Mavanur A. No gender influences on clinical outcomes or durability of repair following carotid angioplasty with stenting and carotid endarterectomy. Vasc Endovascular Surg. 2008;42:321–328Epub 2008 Mar 10

 Competition of interest: none.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(09)01382-2

doi: 10.1016/j.jvs.2009.07.015

Journal of Vascular Surgery
Volume 50, Issue 6 , Pages 1308-1313 , December 2009

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