3、RESULTS
All five patients’ characteristics and previous treatments were demonstrated on Table 1 and Table 2 . The post-stenting angiography (Figure 1B ) demonstrated an improvement in the appearance and caliber of the affected carotid artery. The carotid wall could be dissected from the stent without difficulty and en blocresection of the surrounding tumor with attempted R0 resection.Figure 2A and 2B demonstrated appearance of the covered stent in carotid artery. The mean age was 52.2 years (range, 41-60 years), and the median follow-up was 6.5 months (range, 4-9 months).After placement of the covered stent prior to surgical resections, four patients experienced transient bradycardia (30-40 beats/min)and hypotension (50/30-70/50 mmHg).No stroke occurred in these five patients. Intraoperatively, we noted that in two patients’ the whole carotid artery wall was involved, in two patients’ tumor invaded only the tunica adventitia of the carotid artery, and one other patient’s tumor did not directly invade the carotid artery, there was only extrinsic compression. All five patients underwent R0 resection (no positive margins of the resection line of the specimen) and there were no intraoperative complications .The type of tumor in all patients was squamous cell carcinoma. Postoperatively, all patients healed because of rich vascularity of the flap, and no infection or necrosis occurred. Three patients underwent adjuvant radiotherapy or chemoradiation. With median follow-up 6.5 months, one patient died of multiple organ failures at 6.5 months after surgery; one patient developed tracheal stoma recurrence and was treated with salvage surgery; the three other patients had no disease recurrence at their last follow-up. We have not observed any postoperative spontaneous carotid artery rupture, stroke, or late graft occlusion.