Radiation therapy of the head and neck can result in stenosis of the carotid arteries, especially at the bifurcation..
Risk for carotid artery stenosis:
(1) carotid artery unshielded within the radiation field
(2) higher dose of radiation
(3) risk factors for atherosclerosis (hyperlipidemia, smoking, diabetes mellitus, hypertension)
Radiation therapy in younger patients (<=41 years of age) showed a stronger correlation with radiation therapy than for older patients (Chang et al; Simonetti et al).
Complications:
(1) stroke
A patient at high risk for carotid artery stenosis should:
(1) be screened regularly with Doppler ultrasonography
(2) receive antiplatelet therapy
A patient with significant carotid artery stenosis can undergo stenting or endarterectomy.
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