ArticleJournal of medical case reports2026
Carotid endarterectomy for postradiation carotid stenosis in patient with hypopharyngeal cancer: a case report.
Article in Journal of medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRadiation therapy for head and neck tumors is associated with radiation-induced carotid injury, which increases the risk of carotid artery stenosis and cerebrovascular events. Despite the well-established risks, routine screening for these complications has not been incorporated into clinical practice. This case emphasizes that, despite severe fibrosis and adhesion in the neck tissues resulting from radiation therapy, a well-structured surgical evaluation can still lead to favorable outcomes. It highlights the importance of timely surgical intervention in such cases. CASE PRESENTATION: A 60-year-old male of Asian descent presented with a 1-month history of episodic dizziness, persistent headache, and right lower limb weakness. Imaging studies demonstrated severe stenosis (70-99%) at the origin of the left internal carotid artery, accompanied by reduced cerebral perfusion in the left hemisphere and inadequate collateral circulation. The patient had a prior history of hypopharyngeal cancer treated with surgery, chemotherapy, and radiotherapy 4 years earlier, which subsequently led to radiation-induced carotid artery stenosis. He underwent left carotid endarterectomy, which revealed substantial fibrosis and dense adhesions, complicating the dissection. An eversion technique was employed to achieve complete plaque removal, and postoperative angiography confirmed restored vascular patency. Histopathological analysis showed marked intimal thickening, collagen deposition, and calcification. The patient's recovery was uneventful, with full resolution of symptoms by postoperative day 4 and follow-up imaging demonstrating significantly improved cerebral perfusion.
conclusionCarotid endarterectomy can safely and effectively improve cerebral perfusion and alleviate symptoms in patients with carotid artery stenosis following radiation therapy, provided there is thorough preoperative evaluation and meticulous surgical exposure. In addition, it is essential to strengthen carotid artery assessment and long-term follow-up for survivors of head and neck radiation therapy.
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