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Abstract
The objectives of this study were to assess the effects of irradiation, surgery, radiation with surgery or chemotherapy on the carotid artery in patients with head and neck cancer.
Many reports in the world literature since the 1950s documented that therapeutic radiation exposure to the carotid and other large arteries will result in damage to the vessels over time. These changes were limited to the parts of the vessels that were exposed to the radiations in the form of acute thrombosis, carotid artery blowout, carotid wall thickening and rapid atherosclerosis (carotid occlusive disease). The exact mechanism of radiation injury remains uncertain, but may be injury of the vasa vasorum and peri- adventitial tissues (early), which may progress to late lesion with dense prei- adventitial fibrosis. Irradiation induced damage to the vascular endothelium leading to increased permeability and adherence of platelets to the endothelium, platelets and vascular cells release factors that promote smooth muscle cell proliferations and migration in the media and intima resulting in thickening of the intima.