ABSTRACT
Carotid artery disease is a well-known complication of external beam radiation such as is administered for head and neck cancers. In a long-term followup study of 6 years, Cheng et al. (10) estimated a risk of significant carotid artery stenosis in 11.7% patients after external beam radiation to the head and neck area. Another review of 415 patients who received external beam radiation as treatment for Hodgkin’s lymphoma reported a 7.4% development of carotid and/or subclavian disease at a mean of 17 years following treatment (11). Radiation induced carotid disease has been classified into three subtypes: (i) acute carotid artery rupture, (ii) early carotid artery occlusion, occurring within months, probably the result of direct arterial wall injury, and (iii) chronic late development of occlusion akin to atherosclerosis (12). Rarely, pseudoaneurysm formation has also been described (13). Although the term ‘‘accelerated atherosclerosis’’ is often used, there are some key differences based on the fact that the lesion often affects the common carotid artery, and that long segments of the artery are commonly involved.
