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01-08-2018 | Review Article

Radiation-induced carotid artery lesions

Authors: Verónica Fernández-Alvarez, Fernando López, Carlos Suárez, MD, PhD, Primoz Strojan, Avraham Eisbruch, Carl E. Silver, William M. Mendenhall, Johannes A. Langendijk, Alessandra Rinaldo, Anne W. M. Lee, Jonathan J. Beitler, Robert Smee, Javier Alvarez, Alfio Ferlito

Published in: Strahlentherapie und Onkologie | Issue 8/2018

Abstract

Purpose

To review the current aspects of knowledge related to the risk of cerebrovascular events in patients receiving head and neck radiotherapy.

Methods

A literature search was performed in PubMed. Papers meeting selection criteria were reviewed.

Results

We provide an update on the problem by identifying key studies that have contributed to our current understanding of the epidemiology, radiologic features, pathogenesis, and treatment of the disease. The incidence of carotid artery stenosis ranged from 18 to 38% in patients who underwent radiotherapy for head and neck cancer versus from 0 to 9.2% among the nonirradiated patients. Neck irradiation increases the intima-media thickness of the carotid artery wall. These changes are the earliest visible alteration in the carotid wall and are also detected with color Doppler ultrasonography. Endovascular treatment with a carotid angioplasty and stenting is the first-line treatment for most symptomatic patients.

Conclusions

Radiation-induced atherosclerosis is a different and accelerated form of atherosclerosis, which implies a more aggressive disease with a different biologic behavior. The disease is characterized by a high rate of carotid artery stenosis compared to those observed in nonirradiated control group patients. To prevent the risk of stroke, surveillance and imaging with ultrasonography should enable detection of severe stenosis. Endovascular treatment with a carotid angioplasty and stenting has been proposed as an attractive and minimally invasive alternative for some radiation-induced stenoses.

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Title: Radiation-induced carotid artery lesions
Authors: Verónica Fernández-Alvarez
Fernando López
Carlos Suárez, MD, PhD
Primoz Strojan
Avraham Eisbruch
Carl E. Silver
William M. Mendenhall
Johannes A. Langendijk
Alessandra Rinaldo
Anne W. M. Lee
Jonathan J. Beitler
Robert Smee
Javier Alvarez
Alfio Ferlito
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 8/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1304-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiation-induced carotid artery lesions

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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