Advanced cervical metastasis involving the carotid artery.

Purpose Of Review: This paper will review recent reports of the surgical management of the carotid artery when cancer is adherent to it and will highlight the author's experience at Clarian Health Partners in Indianapolis.

Recent Findings: Recent trends in treating metastatic neck cancer with chemoradiation initially and reserving surgery for the treatment of residual or recurrent disease has tasked the head and neck surgeon with extirpating cancer in significantly altered tissue with loss of tissue planes and scarring that conceals the extent of cancer spread. Cancer that is adherent to the carotid presents a treatment dilemma to the surgeon, given that historically the local control and survival has been dismal and the complications of surgery are high.

Management of neck metastasis with carotid artery involvement.

Objectives: To demonstrate aggressive management of neck metastasis adherent to the internal or common carotid artery using sound oncologic principles while minimizing the significant risk of complications.

Study Design: Our 13 year experience of treating patients with recurrent or residual neck metastasis adherent to the internal or common carotid artery was retrospectively reviewed.

Methods: Angiography was used in patients who demonstrated fixation of the carotid artery on examination or imaging, followed by balloon test occlusion and single photon emission computer tomography (SPECT) scanning.