Imperial College London
Alternate

DR BRAHMAN DHARMARAJAH

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

b.dharmarajah

 
 
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Location

 

Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kasivisvanathan:2012:10.1016/j.jvs.2012.04.044,
author = {Kasivisvanathan, V and Thapar, A and Davies, KJ and Dharmarajah, B and Shalhoub, J and Davies, AH},
doi = {10.1016/j.jvs.2012.04.044},
journal = {Journal of Vascular Surgery},
pages = {1143--1152.e2},
title = {Periprocedural outcomes after surgical revascularization and stenting for postradiotherapy carotid stenosis},
url = {http://dx.doi.org/10.1016/j.jvs.2012.04.044},
volume = {56},
year = {2012}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Treatment of head and neck malignancy commonly involves radiotherapy, which is associated with the development of carotid artery stenosis. There is little evidence to guide clinicians on how to intervene in significant postradiotherapy carotid stenosis. This systematic review collated data pertaining to perioperative outcomes of carotid artery surgery and carotid stenting in postradiotherapy carotid stenosis to aid the clinical decision-making process. Methods: A systematic review of the literature, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines, was performed. We screened 575 articles related to carotid artery surgery or stenting in postradiotherapy carotid stenosis, from which 21 studies were included for quantitative analysis. The primary outcome was stroke or death ≤30 days of the procedure. Secondary outcomes included cranial nerve injury, restenosis, stroke, and death at >30 days. Results: Nine publications recorded 211 surgical procedures in 179 patients. In symptomatic patients, the 30-day mortality rate was 2.6% and the stroke or death rate was 2.7%. In asymptomatic patients, the 30-day mortality rate was 0% and the stroke or death rate was 1.1%. Permanent cranial nerve palsy was experienced by 0.6% of patients. Twelve publications recorded 510 carotid artery stenting procedures in 482 patients. In symptomatic patients, the 30-day mortality rate was 5.1%, and the stroke or death rate was 5.1%. In asymptomatic patients, the 30-day mortality rate was 1.4%, and the stroke or death rate was 2.1%. There was no statistically significant difference in 30-day stroke or death rate between surgical revascularization and carotid artery stenting in all (odds ratio [OR], 0.54; 95% confidence interval [CI] 0.17-1.70; P =.43), symptomatic (OR, 0.52; 95% CI, 0.14-1.98; P =.38), or asymptomatic patients (OR, 0.55; 95% CI, 0.06-5.42; P =.99). Conclusions: The published outcomes from high-volume ce
AU  - Kasivisvanathan,V
AU  - Thapar,A
AU  - Davies,KJ
AU  - Dharmarajah,B
AU  - Shalhoub,J
AU  - Davies,AH
DO  - 10.1016/j.jvs.2012.04.044
EP  - 1152
PY  - 2012///
SN  - 0741-5214
SP  - 1143
TI  - Periprocedural outcomes after surgical revascularization and stenting for postradiotherapy carotid stenosis
T2  - Journal of Vascular Surgery
UR  - http://dx.doi.org/10.1016/j.jvs.2012.04.044
VL  - 56
ER  -
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