Late Outcomes of Carotid Artery Stenting for Radiation Therapy-Induced Carotid Stenosis

A retrospective review of 11 French academic institutions (University Association for Research in Vascular Surgery—AURC) from 2005 to 2017. One hundred and twenty-one transfemoral carotid artery stent (TF-CAS) procedures were performed in 112 patients (31% symptomatic). The mean interval between irradiation and TF-CAS was 15 years. Duplex ultrasound examination was performed at 1, 6, and 12 months, and annually thereafter. The combined 30-day perioperative stroke and mortality rate was 6.5%. After 5 years, the neurologic event-free survival rate was 88% and in-stent restenosis rate was 39%. Diabetes mellitus and single postoperative antiplatelet therapy were significant predictors of in-stent restenosis. TF-CAS is an effective option for radiation-induced stenosis. CAS was associated with low rates of neurological events and reinterventions at a mean follow-up of 3.5 years.