Carotid interposition in patients with head and neck tumors : clinical experience of 13 cases reconstructed with a great saphenous vein autograft

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Abolfotouh , S , Bäck , L , Aro , K , Lassus , P , Vuola , J , Mesimäki , K , Wilkman , T & Vikatmaa , P 2022 , ' Carotid interposition in patients with head and neck tumors : clinical experience of 13 cases reconstructed with a great saphenous vein autograft ' , Acta Oto-Laryngologica , vol. 142 , no. 5 , pp. 419-424 . https://doi.org/10.1080/00016489.2022.2067356

Title: Carotid interposition in patients with head and neck tumors : clinical experience of 13 cases reconstructed with a great saphenous vein autograft
Author: Abolfotouh, Sherif; Bäck, Leif; Aro, Katri; Lassus, Patrik; Vuola, Jyrki; Mesimäki, Karri; Wilkman, Tommy; Vikatmaa, Pirkka
Contributor organization: HUS Musculoskeletal and Plastic Surgery
Plastiikkakirurgian yksikkö
HUS Head and Neck Center
Clinicum
Department of Ophthalmology and Otorhinolaryngology
University of Helsinki
Korva-, nenä- ja kurkkutautien klinikka
Suu- ja leukakirurgian yksikkö
Department of Oral and Maxillofacial Diseases
HUS Abdominal Center
Verisuonikirurgian yksikkö
Date: 2022-05-02
Language: eng
Number of pages: 6
Belongs to series: Acta Oto-Laryngologica
ISSN: 0001-6489
DOI: https://doi.org/10.1080/00016489.2022.2067356
URI: http://hdl.handle.net/10138/346072
Abstract: Background Carotid interposition graft (CIG) surgery in the setting of head & neck cancer (HNC) is a rare procedure with a limited number of cases described in the literature. Aims/Objectives To assess the outcomes of the surgery at Helsinki University Hospital. Materials and methods Patients who underwent CIG in a head and neck tumor surgery were retrospectively analyzed over 15 years. Overall-survival (OS) was calculated until 1 May 2020. The primary-outcome was to measure the 30-day OS, postoperative stroke rate, and other complications. The secondary-outcome was to measure 1-, 2-, and 5-year OS. Results Thirteen patients were identified, 11 with HNC and two with Shamblin III Carotid Body Tumors. The great saphenous vein was used for all vascular reconstructions, and shunting was routinely performed. The 30-day stroke incidence was nil. Two graft-blowouts were encountered, one of which lead to death and the other was successfully managed. For HNC patients, the locoregional recurrence-rate was 36%. The 5-year OS was 46.2%. Conclusion and significance CIG in HNC setting can achieve oncologic-control with an acceptable rate of complications. Routine shunting, heparinization, and elevating blood-pressure during closure seem to be safe protocols to maintain cerebral-circulation perioperatively. A moderate graft-blowout risk should be considered.
Subject: Carotid interposition graft
carotid artery reconstruction
head and neck cancer
surgery
ARTERY RESECTION
MANAGEMENT
REPLACEMENT
SACRIFICE
SURGERY
CANCER
COMMON
GRAFT
3125 Otorhinolaryngology, ophthalmology
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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