Feasibility and safety of intracranial carotid implantation with covered stents for advanced head and neck squamous cell carcinoma involving the carotid artery: A preliminary investigation

Abstract Objective The aim of this study was to assess the feasibility and safety of implanting covered stents in cases of advanced head and neck squamous cell carcinoma (ASCCHN) where the carotid artery was involved. Methods A total of 30 patients (29 males and one female) were included in this study, with ages ranging from 40 to 79 years. Among these patients, 28 patients had received radiotherapy and 17 received subsequent adjuvant therapy, while one was receiving treatment for the first time. Eighteen were treated with covered stent implantation in conjunction with surgery, and the remaining 12 received stent implantation alone. The study evaluated and compared the stent implantation's success rate, overall survival (OS), and associated complications. Results Successful implantation of covered stents was achieved in all 30 cases. No instances of significant hemorrhage or thromboembolic cerebral infarction occurred during surgery. Of the patients in the salvage surgical group, 15 underwent complete tumor resection with a success rate of 83.3% (15/18), of which four experienced tumor recurrence with a local recurrence rate of 26.7% (4/15). The OS rates at 6 months for all patients, the salvage surgical group, the 15 patients with complete tumor resection, and the nonsurgical group were 64.0%, 66.8%, 75.5%, and 58.6%, respectively. At 12 months, the OS rates were 21.4%, 29.3%, 43.2%, and 11.8%, respectively. Notably, the OS of the 15 patients who underwent complete tumor resection was significantly higher than that of the 12 patients who received stent implantation alone ( p = 0.044). All cerebrovascular accidents occurred in patients with radiotherapy history, and subsequent adjuvant therapy had no significant effect on the OS time in the salvage surgical and nonsurgical groups ( p = 0.935; p = 0.526). Conclusion In cases of ASCCHN involving the carotid artery, the implantation of covered stents is a safe and feasible procedure.