Stent-assisted Angioplasty for Symptomatic Radiation-induced Carotid Stenosis

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.