Pavlos Texakalidis1, Stefanos Giannopoulos2, Ioannis Tsouknidas3, Shiyu Song4, Dennis J Rivet5, Evan R Reiter6, John Reavey-Cantwell5. 1. Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia. 2. Department of Cardiology, University of Colorado, Denver, Colorado. 3. Department of Vascular Surgery, Naval and Veterans Hospital of Athens, Athens, Greece. 4. Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia. 5. Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia. 6. Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia.
Abstract
BACKGROUND: Radiation to the head and neck is a well-established risk factor for the development of carotid artery stenosis. Our objective was to identify the prevalence, incidence, and degree of carotid stenosis in patients with a history of head and neck irradiation. METHODS: This study was performed according to the PRISMA guidelines. A random effects model meta-analysis was conducted. RESULTS: Nineteen studies comprising 1479 patients were included. The prevalence of carotid stenosis >50%, >70%, and carotid occlusion was 25% (95% CI: 19%-32%), 12% (95% CI: 7%-17%), and 4% (95% CI: 2%-8%), respectively. The cumulative 12-month incidence of carotid stenosis >50% was 4% (95% CI: 2%-5%), the 24-month was 12% (95% CI: 9%-15%), and the 36-month was 21% (95% CI: 9%-36%). CONCLUSIONS: The yearly incidence of carotid stenosis >50% increased every year during the first 3 years following radiotherapy. We propose routine yearly Doppler ultrasound screening beginning 1 year after head and neck radiotherapy.
BACKGROUND: Radiation to the head and neck is a well-established risk factor for the development of carotid artery stenosis. Our objective was to identify the prevalence, incidence, and degree of carotid stenosis in patients with a history of head and neck irradiation. METHODS: This study was performed according to the PRISMA guidelines. A random effects model meta-analysis was conducted. RESULTS: Nineteen studies comprising 1479 patients were included. The prevalence of carotid stenosis >50%, >70%, and carotid occlusion was 25% (95% CI: 19%-32%), 12% (95% CI: 7%-17%), and 4% (95% CI: 2%-8%), respectively. The cumulative 12-month incidence of carotid stenosis >50% was 4% (95% CI: 2%-5%), the 24-month was 12% (95% CI: 9%-15%), and the 36-month was 21% (95% CI: 9%-36%). CONCLUSIONS: The yearly incidence of carotid stenosis >50% increased every year during the first 3 years following radiotherapy. We propose routine yearly Doppler ultrasound screening beginning 1 year after head and neck radiotherapy.
Authors: Verónica Fernández-Alvarez; Miriam Linares Sánchez; Fernando López Alvarez; Carlos Suárez Nieto; Antti A Mäkitie; Kerry D Olsen; Alfio Ferlito Journal: Cardiol Ther Date: 2022-04-01