Application of endovascular stent graft in treatment of advanced head and neck malignancies involving carotid arteries and their complications
Zhang Haidong1,2, Yu Zhenkun1,2
1Clinical Medicine Department,School of Medicine, Southeast University, Nanjing 210096,China; 2Department of Otorhinolaryngology and Head and Neck Surgery, the Affiliated BenQ Hospital of Nanjing Medical University, Nanjing 210096, China
Abstract：Objective This study aimed to summarize the application of endovascular stent graft (ESG) in salvage treatment of advanced head and neck malignancies involving carotid artery and their complications. Methods Literature on the role of ESG in treating advanced head and neck malignancies involving carotid arteries and their complications was searched in NCBI, Web of Science, CNKI, and Wanfang databases from January 2000 to January 2023. A total of 765 literature were included, excluding irrelevant literature, duplicate literature, unable-to-obtain-full-text literature, review literature, and literature with poor research quality. Finally, 40 relevant literature was included for analysis. Results For advanced head and neck malignancies involving the carotid artery, ESG combined with surgical resection can remove the tumor without affecting the carotid blood flow, thus minimizing the potential risk of intraoperative and postoperative neurological sequelae. In the treatment of complications of advanced head and neck malignancies, ESG is a safe and effective approach for treating carotid burst syndrome. It reduces the risk of ischemic complications associated with intravascular or surgical carotid artery sacrifice, but the potential for delayed ischemic or infectious complications should not be ignored. For radiation-induced carotid stenosis (RICS) after radiotherapy for head and neck malignancies, ESG treatment can effectively improve RICS and reduce the incidence of ischemic cardiovascular and cerebrovascular events, with positive short-term effects. However, further observation is needed in terms of arterial restenosis and ischemic cardiovascular and cerebrovascular events. Thrombosis and aneurysm formation in ESG are common complications of ESG implantation, and the preventive measures need to be further explored. Conclusion ESG intraarterial placement is a reliable option for surgical treatment of head and neck malignancies involving carotid artery and salvage treatment of their complications.
张海东, 于振坤. 支架-人造血管复合体移植物在累及颈动脉的晚期头颈恶性肿瘤及其并发症治疗中的应用进展[J]. 中华解剖与临床杂志, 2023, 28(8): 562-566.
Zhang Haidong, Yu Zhenkun. Application of endovascular stent graft in treatment of advanced head and neck malignancies involving carotid arteries and their complications. Chinese Journal of Anatomy and Clinics, 2023, 28(8): 562-566.
Kamran M, Wallace AN, Adewumi A.Interventional management of head and neck tumors[J]. Semin Intervent Radiol, 2020, 37(2):157-165. DOI: 10.1055/s-0040-1709157
[2]
Kocarnik JM, Compton K, Dean FE, et al.Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the global burden of disease study 2019[J]. JAMA Oncol, 2022,8(3):420-444. DOI: 10.1001/jamaoncol.2021.6987
[3]
Chow L.Head and Neck Cancer[J]. N Engl J Med, 2020,382(1):60-72. DOI: 10.1056/NEJMra1715715
[4]
Krol E, Brandt CT, Blakeslee-Carter J, et al.Vascular interventions in head and neck cancer patients as a marker of poor survival[J]. J Vasc Surg, 2019,69(1):181-189. DOI: 10.1016/j.jvs.2018.04.058
[5]
Kontopodis N, Igoumenakis D, Mastorakis G, et al.Local metastatic neck cancer involving the distal internal carotid artery treated with en bloc resection and arterial reconstruction after mandibular osteotomy[J]. Vasc Specialist Int, 2020,36(4):252-257. DOI: 10.5758/vsi.200046
[6]
Kim Y, Philouze P, Malard O, et al.Resection and reconstruction of the carotid artery for head and neck squamous cell carcinoma: a GETTEC study[J]. Eur Arch Otorhinolaryngol, 2022,279(9):4515-4523. DOI: 10.1007/s00405-022-07342-6
[7]
Shah H, Gemmete JJ, Chaudhary N, et al.Acute life-threatening hemorrhage in patients with head and neck cancer presenting with carotid blowout syndrome: follow-up results after initial hemostasis with covered-stent placement[J]. AJNR Am J Neuroradiol, 2011,32(4):743-747. DOI: 10.3174/ajnr.A2379
[8]
Wu CJ, Lin WC, Hsu JS, et al.Follow-up for covered stent treatment of carotid blow-out syndrome in patients with head and neck cancer[J]. Br J Radiol, 2016,89(1058):20150136. DOI: 10.1259/bjr.20150136
[9]
Gaynor BG, Haussen DC, Ambekar S, et al.Covered stents for the prevention and treatment of carotid blowout syndrome[J]. Neurosurgery, 2015,77(2):164-167. DOI: 10.1227/NEU.0000000000000738
[10]
Wong D, Donaldson C, Lai LT, et al.Safety and effectiveness of endovascular embolization or stent-graft reconstruction for treatment of acute carotid blowout syndrome in patients with head and neck cancer: case series and systematic review of observational studies[J]. Head Neck, 2018,40(4):846-854. DOI: 10.1002/hed.25018
[11]
Manzoor NF, Russell JO, Bricker A, et al.Impact of surgical resection on survival in patients with advanced head and neck cancer involving the carotid artery[J]. JAMA Otolaryngol Head Neck Surg, 2013,139(11):1219-1225. DOI: 10.1001/jamaoto.2013.4917
[12]
Ricco JB, Illuminati G, Belmonte R.Resection of recurrent neck cancers with replacement of the carotid artery[J]. J Med Vasc, 2017,42(5):282-289. DOI: 10.1016/j.jdmv.2017.07.003
[13]
Elbers J, Al-Mamgani A, van den Brekel M, et al. Salvage surgery for recurrence after radiotherapy for squamous cell carcinoma of the head and neck[J]. Otolaryngol Head Neck Surg, 2019,160(6):1023-1033. DOI: 10.1177/0194599818818443
[14]
Ozer E, Agrawal A, Ozer HG, et al.The impact of surgery in the management of the head and neck carcinoma involving the carotid artery[J]. Laryngoscope, 2008,118(10):1771-1774. DOI: 10.1097/MLG.0b013e31817f6dc7
[15]
Lee YG, Kang EJ, Keam B, et al.Treatment strategy and outcomes in locally advanced head and neck squamous cell carcinoma: a nationwide retrospective cohort study (KCSG HN13-01)[J]. BMC Cancer, 2020,20(1):813. DOI: 10.1186/s12885-020-07297-z
[16]
de Donato G, Pasqui E, Panzano C, et al. The polymer-based technology in the endovascular treatment of abdominal aortic aneurysms[J]. Polymers (Basel), 2021,13(8): 1196. DOI: 10.3390/polym13081196
[17]
Kassier A, Fischell TA.Managing coronary artery perforation after percutaneous coronary intervention[J]. Expert Rev Cardiovasc Ther, 2022,20(3):215-222. DOI: 10.1080/14779072.2022.2059465
[18]
郑磊,马博,徐坤,等. 覆膜支架与裸支架治疗人工血管动静脉内瘘静脉吻合口狭窄的疗效[J]. 血管与腔内血管外科杂志,2021,7(2):129-134. DOI: 10.19418/j.cnki.issn.2096-0646. 2021.02.02.Zheng L, Ma B, Xu K, et al.Clinical effectiveness of stent-graft versus bare metal stent in treating venous anastomotic stenosis of arteriovenous graft[J]. Journal of Vascular and Endovascular Surgery, 2021,7(2):129-134. DOI: 10.19418/j.cnki.issn.2096-0646.2021.02.02
[19]
杨少飞,杨光华,浦佳希,等. 动脉覆膜支架在复杂颈动脉体瘤切除术中应用的单中心回顾性研究[J]. 外科理论与实践,2022,27(1):66-69. DOI: 10.16139/j.1007-9610.2022.01.015.Yang SF, Yang GH, Pu JX, et al.Arterial covered stent used in resection of complex carotid body tumor: a single-center retrospective study[J]. J Surg Concepts Pract, 2022,27(1):66-69. DOI: 10.16139/j.1007-9610.2022.01.015
[20]
Markiewicz MR, Pirgousis P, Bryant C, et al.Preoperative protective endovascular covered stent placement followed by surgery for management of the cervical common and internal carotid arteries with tumor encasement[J]. J Neurol Surg B Skull Base, 2017, 78(1):52-58. DOI: 10.1055/s-0036-1584298
[21]
赵珍, 李睿聪, 景尚华. 覆膜支架联合手术治疗头颈部癌侵犯颈动脉在绵羊模型中的试验性研究[J]. 河北医科大学学报, 2020, 41(6):637-640,645. DOI: 10.3969/j.issn.1007-3205. 2020.06.005.Zhao Z,Li RC,Jing SH.An experimental study of covered stent combining with surgery in the treatment of head and neck cancer invading carotid artery in sheep model[J]. Journal of Hebei Medical University, 2020, 41(6):637-640,645. DOI:10.3969/j.issn.1007-3205.2020.06.005
[22]
Liu K, Zhang H, Jiang H, et al.Oncologic surgical resection with intravascular covered stent placement in patients with carotid artery encased by metastatic cancer-our experience with 5 patients[J]. Clin Otolaryngol, 2022,47(2):336-340. DOI: 10.1111/coa.13893
[23]
McDonald MW, Moore MG, Johnstone PA. Risk of carotid blowout after reirradiation of the head and neck: a systematic review[J]. Int J Radiat Oncol Biol Phys, 2012,82(3):1083-1089. DOI: 10.1016/j.ijrobp.2010.08.029
[24]
Suárez C, Fernández-Alvarez V, Hamoir M, et al.Carotid blowout syndrome: modern trends in management[J]. Cancer Manag Res, 2018,10:5617-5628. DOI: 10.2147/CMAR.S180164
[25]
Chen YJ, Wang CP, Wang CC, et al.Carotid blowout in patients with head and neck cancer: associated factors and treatment outcomes[J]. Head Neck, 2015,37(2):265-272. DOI: 10.1002/hed.23590
[26]
Liang NL, Guedes BD, Duvvuri U, et al.Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer[J]. J Vasc Surg, 2016,63(6):1525-1530. DOI: 10.1016/j.jvs.2015.12.047
[27]
Silverman DA, Parikh AS, Liu K, et al.Predictors of survival following carotid blowout syndrome[J]. Oral Oncol, 2022,125:105723. DOI: 10.1016/j.oraloncology.2022.105723
[28]
Weinberg JH, Sweid A, Joffe D, et al.Carotid blowout management in the endovascular era[J]. World Neurosurg, 2020, 141:e1010-e1016. DOI: 10.1016/j.wneu.2020.06.151
[29]
Lesley WS, Chaloupka JC, Weigele JB, et al.Preliminary experience with endovascular reconstruction for the management of carotid blowout syndrome[J]. AJNR Am J Neuroradiol, 2003, 24(5):975-981
[30]
Ferris RL, Moskovitz J, Kunning S, et al.Phase I trial of cetuximab, radiotherapy, and ipilimumab in locally advanced head and neck cancer[J]. Clin Cancer Res, 2022,28(7):1335-1344. DOI: 10.1158/1078-0432.CCR-21-0426
[31]
Greco A, Gallo A, De Virgilio A, et al.Carotid stenosis after adjuvant cervical radiotherapy in patients with head and neck cancers: a prospective controlled study[J]. Clin Otolaryngol, 2012,37(5):376-381. DOI: 10.1111/coa.12007
[32]
Chen X, Zheng Y, Tatsuoka C, et al.Chemoradiotherapy-related carotid artery inflammation in head and neck cancer patients quantified by [(18)F]FDG PET/CT[J]. Oral Oncol, 2019,93:101-106. DOI: 10.1016/j.oraloncology.2019.04.008
[33]
Liao W, Zheng Y, Bi S, et al.Carotid stenosis prevalence after radiotherapy in nasopharyngeal carcinoma: a meta-analysis[J]. Radiother Oncol, 2019,133:167-175. DOI: 10.1016/j.radonc.2018.11.013
[34]
Valentin ML, Barco S, Studer G, et al.Prevalence of carotid plaque stenosis after head and neck radiotherapy - an observational study of 156 survivors[J]. Vasak, 2020, 49(6):467-473. DOI: 10.1024/0301-1526/a000896
[35]
Vos JA, Van Leersum M, De Vries JP.Is a history of radiation therapy a contraindication for carotid surgery?[J]. J Cardiovasc Surg (Torino), 2016, 57(2):158-161
[36]
Tallarita T, Oderich GS, Lanzino G, et al. Outcomes of carotid artery stenting versus historical surgical controls for radiation-induced carotid stenosis[J]. J Vasc Surg, 2011,53(3):629-636.e1-e5. DOI: 10.1016/j.jvs.2010.09.056
[37]
Trojanowski P, Sojka M, Trojanowska A, et al.Management of radiation induced carotid stenosis in head and neck cancer[J]. Transl Oncol, 2019,12(8):1026-1031. DOI: 10.1016/j.tranon.2019.05.001
[38]
Ravin RA, Gottlieb A, Pasternac K, et al.Carotid artery stenting may be performed safely in patients with radiation therapy-associated carotid stenosis without increased restenosis or target lesion revascularization[J]. J Vasc Surg, 2015,62(3):624-630. DOI: 10.1016/j.jvs.2015.04.390
[39]
Bäck L, Aro K, Tapiovaara L, et al.Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: review and meta-analysis[J]. Head Neck, 2018,40(6):1305-1320. DOI: 10.1002/hed.25093
[40]
Chang FC, Luo CB, Lirng JF, et al.Endovascular management of post-irradiated carotid blowout syndrome[J]. PLoS One, 2015,10(10):e0139821. DOI: 10.1371/journal.pone.0139821
2023, Vol. 28 
