[Radiation-induced lesions of carotid arteries: report of five cases].

This paper is aimed at the analysis and discussion of a personal experience with an unusual entity, the radiation-induced lesions of carotid arteries, based on 5 patients that were observed for the last twelve years. The series is composed of 4 men and woman, with an average age of 65 (between 51 to 77). Malignancies that required radiotherapy were diverse and the carotid lesions were recognized between 8 and 20 years after the irradiation (average 15) . They consisted in 3 occlusions and 5 stenosis of the internal carotid, 4 occlusions of the external carotid, and 2 stenosis of the common carotid artery. Four patients presented with symptoms of cerebrovascular insufficiency and 1 was asymptomatic. Three patients underwent 4 surgical procedures (1 bilateral) which consisted uniformly in the segmental resection of the stenosed arteries followed by its replacement with a graft, autologous or prosthetic. There was no operative mortality, nor significant morbidity. The main features of etiopathogeny, diagnosis and treatment of this entity are discussed, based on data published in literature, where a controversy between conventional surgery and endovascular management is evident. Conventional surgery is recognized as an effective method, bearing excellent and durable results. Endovascular management requires more consistent and long-lasting results, to be confirmed and assumed as a reliable alternative to the surgical treatment of this peculiar form of carotid arteries pathology.