Radiation-induced carotid artery lesions

Area of Science:

• Vascular Surgery
• Radiation Oncology
• Neurology

Background:

• Head and neck radiotherapy is a common treatment for various cancers.
• Cerebrovascular events are a significant concern in patients undergoing such treatments.
• Radiation-induced atherosclerosis presents a unique challenge in managing these patients.

Purpose of the Study:

• To review current knowledge on cerebrovascular event risk in patients receiving head and neck radiotherapy.
• To update understanding of the epidemiology, pathogenesis, and treatment of radiation-induced carotid artery disease.

Main Methods:

• A comprehensive literature search was conducted in PubMed.
• Relevant papers meeting selection criteria were reviewed and analyzed.

Main Results:

• Head and neck irradiation is associated with a 18-38% incidence of carotid artery stenosis, significantly higher than the 0-9.2% in non-irradiated patients.
• Neck irradiation accelerates atherosclerosis, increasing intima-media thickness detectable by ultrasonography.
• Carotid angioplasty with stenting is a primary treatment for symptomatic patients.

Conclusions:

• Radiation-induced atherosclerosis is an aggressive form of the disease, distinct from typical atherosclerosis.
• Surveillance with ultrasonography is crucial for detecting severe stenosis and preventing stroke.
• Endovascular treatment offers a minimally invasive option for radiation-induced carotid stenosis.