{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:00:18Z","timestamp":1787871618372,"version":"build-2784847793"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>Patients with both carotid stenosis and previously cervical radiation therapy are considered \u201chigh risk\u201d for carotid endarterectomy (CEA). Carotid angioplasty and stenting (CAS) seems a reasonable alternative, but neither the operative risk for CEA nor the effectiveness of CAS has been proven. The purpose of this study was to evaluate perioperative and long-term outcome of both procedures in patients with radiation therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>A systematic search strategy with the synonyms \u201ccarotid artery stenosis\u201d and \u201ccervical irradiation\u201d was conducted in MEDLINE and EMBASE databases. To provide and compare estimates of outcomes, pooled and metaregression analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      Twenty-seven articles comprising 533 patients undergoing radiation therapy (361 CAS and 172 CEA) fulfilled our inclusion criteria. Pooled analysis showed perioperative risk for \u201cany cerebrovascular adverse event\u201d (CVE) of 3.9% (95% CI, 2.3%\u20136.7%) in CAS studies against 3.5% (95% CI, 1.5%\u20138.0%) in CEA studies (\n                      <jats:italic>P<\/jats:italic>\n                      =0.77). Risk for cranial nerve injury (CNI) after CEA was 9.2% (95% CI, 3.7%\u201321.1%) versus none after CAS. Late outcome showed rates of CVE favoring CEA (\n                      <jats:italic>P<\/jats:italic>\n                      =0.014). The rate of restenosis &gt;50% was significantly higher in patients treated with CAS compared with CEA (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Both CAS and CEA proved to be feasible revascularization techniques with low risk for CVE. Although patients undergoing CEA had more temporary CNI, higher rates of late CVE and restenosis were identified after CAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.111.633743","type":"journal-article","created":{"date-parts":[[2011,12,29]],"date-time":"2011-12-29T23:02:50Z","timestamp":1325199770000},"page":"793-801","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":129,"title":["Stenting Versus Surgery in Patients With Carotid Stenosis After Previous Cervical Radiation Therapy"],"prefix":"10.1161","volume":"43","author":[{"given":"Margriet","family":"Fokkema","sequence":"first","affiliation":[{"name":"From the Department of Vascular Surgery (M.F., A.G.d.H., F.L.M., G.J.d.B.) and the Julius Center for Health Sciences and Primary Care (M.L.B., I.v.d.T.), University Medical Center  Utrecht,  Utrecht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne G.","family":"den Hartog","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (M.F., A.G.d.H., F.L.M., G.J.d.B.) and the Julius Center for Health Sciences and Primary Care (M.L.B., I.v.d.T.), University Medical Center  Utrecht,  Utrecht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel L.","family":"Bots","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (M.F., A.G.d.H., F.L.M., G.J.d.B.) and the Julius Center for Health Sciences and Primary Care (M.L.B., I.v.d.T.), University Medical Center  Utrecht,  Utrecht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingeborg","family":"van der Tweel","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (M.F., A.G.d.H., F.L.M., G.J.d.B.) and the Julius Center for Health Sciences and Primary Care (M.L.B., I.v.d.T.), University Medical Center  Utrecht,  Utrecht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans L.","family":"Moll","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (M.F., A.G.d.H., F.L.M., G.J.d.B.) and the Julius Center for Health Sciences and Primary Care (M.L.B., I.v.d.T.), University Medical Center  Utrecht,  Utrecht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert Jan","family":"de Borst","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (M.F., A.G.d.H., F.L.M., G.J.d.B.) and the Julius Center for Health Sciences and Primary Care (M.L.B., I.v.d.T.), University Medical Center  Utrecht,  Utrecht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040127"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708028"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.113.10.e409"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.12.053"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.03.044"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.04.066"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.12.049"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2008.04808.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02693794"},{"key":"e_1_3_2_11_2","first-page":"1249","article-title":"Radiotherapy of the neck as a risk factor for stroke","volume":"149","author":"Dorresteijn LD","year":"2005","unstructured":"Dorresteijn LD, Marres HA, Bartelink H, Kappelle LJ, Boogerd W, Kappelle AC. 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