Document resource
Background Radiation therapy-induced carotid artery stenosis (RICAS) is an increasingly recognized late complication among head and neck cancer survivors. Carotid artery stenting (CAS) is often favored over endarterectomy in this population; however, outcomes after carotid artery stenting (CAS) remain poorly defined, with limited prior series.Methods We retrospectively identified head and neck cancer survivors treated with RT who underwent CAS between 2016-2025 at a tertiary cancer center. Clinical characteristics, procedural details, and outcomes including stroke, restenosis, and mortality were analyzed.Results A total of 105 patients underwent CAS for RICAS. Median interval from RT to CAS was 10 years (IQR 6-15), with median follow-up of 1.4 years. CAS was performed for symptomatic disease in 29% and asymptomatic stenosis in 71%. Embolic protection was used in 94%. Ipsilateral stroke occurred in 1.9% at 30 days and 3.8% at 1 year, comparable to reported rates in non-radiated populations. In-stent restenosis occurred in 7% at 1 year (12% at median 1.8 years), with 7% requiring reintervention. Thirty-day mortality was 1%, and overall all-cause mortality was 13%.Conclusion In the largest reported single-center cohort of patients with radiation-induced carotid stenosis, carotid artery stenting demonstrates stroke and restenosis rates comparable to the general population, supporting its safety and effectiveness in this high-risk and growing patient populationDisclosures C. Young: None. E. Triantafyllou: None. A. Fernandez: None. J. Shen: None. M. Naser: None. A. Deswal: None. C. Fuller: None. E. Mouhayar: None. E. Koutroumpakis: None. S. Chen: None.