Carotid Artery Sacrifice and Reconstruction in the Setting of Advanced XXXX .

@entity1 @entity135
OBJECTIVE: To determine oncological and neuromorbidity outcomes in @entity1 with advanced @entity135 (stage IVB) requiring sacrifice and reconstruction of the carotid artery. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care referral center. SUBJECTS AND METHODS: Overall, 51 @entity1 underwent carotid artery sacrifice during surgical treatment of the neck, in both the primary and salvage setting. All @entity1 underwent autogenous in-line carotid artery bypass grafting with either saphenous vein or the deep femoral vein in conjunction with vascular surgery. In all, the study included 39 males and 12 female subjects, with age ranging from 39 to 82 (mean, 62.7). RESULTS: Two @entity1 (3.9%) had a cerebral vascular accident in the immediate postoperative period. The remaining 49 @entity1 (96%) had no neurologic sequela. Serial ultrasonic evaluation revealed 4 @entity1 with intra-luminal thrombus within the site of reconstruction. Perioperative mortality occurred in a single @entity1 . Disease-related mortality occurred in 9.8% (5) of @entity1 , with an overall 2-year survival of 82%. CONCLUSIONS: We presently report the largest series of surgical treatment for advanced @entity135 with carotid artery involvement. We document an overall 2-year survival of 82% in the setting of low perioperative neuromorbidity and mortality rates. We therefore consider carotid artery sacrifice and autogenous vein graft reconstruction in the absence of distant metastatic disease as a viable treatment option for what was once thought to be a palliative procedure.
