Patients who have undergone head and neck radiotherapy are at increased risk for severe and extensive carotid artery atherosclerosis, warranting routine surveillance with duplex ultrasound.
Highlights post-radiotherapy carotid atherosclerosis risk; leaves open optimal surveillance strategies pending prospective data.
Radiation induced atherosclerosis of the carotid artery is a clinically relevant late complication after head and neck radiotherapy. Improved long-term survival after multimodality therapy in neck malignancies result in an increased risk of carotid artery disease in patients after radiotherapy (RT). This review focuses on the current knowledge of occlusive carotid disease after head and neck radiotherapy and highlights the exceeding morphologic post-radiation vessel wall pathologies. More severe and extensive carotid artery atherosclerosis with plaque in all segments including the common carotid artery is a frequent finding after RT. Therefore, colour coded duplex ultrasound surveillance in patients after head and neck RT is recommended. Some histopathological studies indicate differences to classical atherosclerosis, and pathogenesis of chronic radiation vasculopathy is still under discussion.
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Thalhammer et al. (2014) studied this question.
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