Endovascular recanalization of the common carotid artery in a patient with radio induced chronic occlusion

BMJ Case Rep. 2016 Nov 1:2016:bcr2016012722. doi: 10.1136/bcr-2016-012722.

Abstract

Recanalization of chronic occlusion of the common carotid artery (CCA) in patients with a history of neck irradiation is challenging, both for vascular surgeons and interventional neuroradiologists. We describe a case of successful stenting of radio induced chronic occlusion of the right CCA in a 41-year-old patient with neurological deterioration and minor stroke due to cerebral hypoperfusion caused by concomitant bilateral arterial occlusions. Direct surgery and surgical bypass were considered contraindicated. The endovascular approach was successful and required multiple precautions during the procedure. We describe particular solutions, not used in day to day practice, that allowed us to carry out the endovascular treatment in this unusual situation.

Keywords: Balloon; Intervention; Stenosis; Stent; Technique.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / etiology
  • Brain Ischemia / surgery
  • Carcinoma / radiotherapy*
  • Carotid Artery, Common / drug effects
  • Carotid Artery, Common / radiation effects
  • Carotid Artery, Common / surgery*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / etiology
  • Carotid Stenosis / surgery*
  • Cerebral Revascularization
  • Computed Tomography Angiography
  • Endovascular Procedures*
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Oropharyngeal Neoplasms / radiotherapy*
  • Radiation Injuries / etiology
  • Radiotherapy / adverse effects
  • Single Photon Emission Computed Tomography Computed Tomography
  • Stents
  • Ultrasonography, Doppler, Color