CAROTID RESECTION AND REPLACEMENT WITH AUTOGENOUS ARTERIAL GRAFT DURING OPERATION FOR NECK MALIGNANCY

Carotid artery resection as part of the management of advanced head an d neck cancers remains controversial. Since 1991, 30 patients have und ergone resection of the carotid artery with immediate reconstruction u sing superficial femoral artery as replacement conduit. There was one stroke/death. Forty-three percent developed neck wound problems but no grafts failed or hemorrhaged. Mean follow-up was 20 months (3-76) and mean life expectancy was 16 months from the time of surgery. Fifty-ei ght percent were free of local recurrence at the time of death. There was a 35% disease-free survival rate at 2 years. These results compare favorably with alternative therapy including carotid ligation or shav ing tumor from the carotid artery. Given the importance of cerebral pe rfusion and local tumor control we offer superficial femoral artery as a durable conduit for immediate extracranial carotid reconstruction i n the often hostile environment associated with cancer resection in th e neck.