Preoperative Protective Endovascular Covered Stent Placement Followed by Surgery for Management of the Cervical Common and Internal Carotid Arteries with Tumor Encasement

Abstract

<b>Objective</b> The objective of this study was to report the outcomes on a preliminary cohort of patients with tumor encasement of either, or both, the cervical internal carotid artery (ICA) and common carotid artery (CCA) following preoperative covered stent placement and surgical resection. <b>Setting</b> This study was set at the University of Florida College of Medicine, Jacksonville, FL. <b>Participants</b> Subjects who received preoperative stenting of the cervical ICA/CCA before surgical resection of head and neck tumors between April 1, 2015, and July 31, 2015 were participated. <b>Main Outcome Measures</b> The outcomes assessed were resectability of tumors after stenting, histopathological assessment of specimen margins, complications associated with stenting. <b>Results</b> Five subjects received preoperative covered stent placement of the ICA/CCA before surgical resection. The mean age was 65.2 years. Median follow-up was 3.5 months. Excision of the adventitia from the stent was performed in all subjects. No intraoperative complications occurred. One vascular-related complication occurred in one subject who suffered occlusion of the stent, sustaining a ministroke. No involvement of tumor at the deep margin (inner surface of adventitia) of the resection was seen in any subjects. <b>Conclusions</b> Preoperative covered stent placement of the cervical ICA/CCA in the management of subjects with head and neck tumors who display encasement on preoperative imaging may represent a safe and effective treatment.