放射后鼻咽坏死 (PRNN) 侵袭颈内动脉 (ICA) 是导致 69.2-72.7% PRNN 患者死亡的原因。ICA 封堵是避免致命出血的有效治疗方法，但一些患者不能耐受。我们提出了一种新方法，可以在不中断 ICA 血流的情况下为这些患者提供治疗。本研究招募了 2020 年 4 月至 2022 年 11 月间 PRNN 侵袭 ICA 且不适合进行 ICA 封堵治疗的患者。36 名患者接受了 ICA 支架预处理，接着进行内窥镜下鼻咽切除术 (ENPG) 或保守治疗。我们报告了支架植入后的生存结局和并发症发生率，并比较了进行 ENPG 和保守治疗后支架植入的生存结局。36 名招募的患者中进行了 ICA 支架预处理，其中 14 名接受了 ENPG，22 名接受了保守治疗。经过中位随访 15 个月，有 27.8% 的患者死亡。ENPG 组的总体生存率 Kaplan-Meier 估计高于保守治疗组。ENPG 组的 Karnofsky 绩效评分 (KPS) 明显高于非 ENPG 组。ICA 支架的创新应用是一种有希望的治疗方法，可以改善无法进行 ICA 栓塞的 PRNN 侵袭 ICA 患者的预后，特别是在内窥镜手术后。然而，避免术后脑缺血和鼻咽出血的方法仍需进一步研究。

Post radiation nasopharyngeal necrosis (PRNN) invading the internal carotid artery (ICA) contributes to the death of 69.2-72.7% of PRNN patients. ICA occlusion is an effective treatment to avoid fatal bleeding, while some patients are intolerant. We present a novel method that allows for these patients without interrupting blood flow through the ICA.This study enrolled patients with PRNN-invaded ICA who were not suitable for ICA occlusion from April 2020 to November 2022. ICA stent pretreatment was performed in the 36 patients and followed the endoscopic nasopharyngectomy (ENPG) or conservative treatment for PRNN. We report the survival outcome and incidence of complications after stent implantation and compare the survival outcomes of ENPG and conservative treatment for PRNN followed by stent implantation.ICA stent pretreatment was performed in the 36 enrolled patients, among which 14 underwent ENPG, and 22 received conservative treatment. 27.8% patients died after a median follow-up of 15 months. The Kaplan-Meier estimates of overall survival were higher in the ENPG group than in the conservative treatment group. Karnofsky performance status (KPS) was significantly higher in the ENPG group than in the non-ENPG group.The innovative application of ICA stents is a promising treatment to improve outcomes in patients with PRNN invading the ICA who are unsuitable for ICA embolization, especially when followed by endoscopic surgery. However, methods to avoid postoperative cerebral ischemia and nasopharyngeal hemorrhage still require further study.