One stage carotid artery resection: Reconstruction in radiated head and neck carcinoma

Purpose: Management of the carotid artery involved with metastatic squamous cell carcinoma continues to be a topic of much discussion. Early reports, for the most part, focused on the sequel of ligation and the development of various tests to predict patient tolerance for the procedure. More recent alternatives have described resection reconstruction in multistage procedur es. By using immediate reconstruction with autogenous arterial grafting, ca rotid artery resection can be accomplished in patients with radiation failu re in a single stage. This technique can be used without the addition of my ocutaneous flaps, controlled fistulas, or intracranial surgery advocated fo r usage with alternative techniques. Patients and Methods: Immediate reconstruction after resection of the carot id artery with superficial femoral arterial graft is described. Results: In a series of 1.8 high-risk patients with radiation failure, the artery was successfully resected and reconstructed in 1 stage without any n eurologic or vascular complications. The technique has been associated with prolonged survival in selected patients. Conclusion: Carotid artery resection and immediate reconstruction can be pe rformed in high-risk radiation failure patients with acceptable complicatio ns, and is associated with prolonged survival in selected cases. (Am J Otol aryngol 2001;22:167-171. Copyright (C) 2001 by W.B. Saunders Company).