Coronary Artery Calcification and Carotid Artery Stenosis as Late Cardiovascular Effects of Radiotherapy for Parotid Gland Malignancy: A Case Report and Clinical Considerations

We report the case of a 73-year-old man with a 60-year history of smoking. He was diagnosed with a parotid malignancy in 2003 and underwent surgical resection. In 2008, radiotherapy was administered due to tumor recurrence. In 2024, severe stenosis of the carotid artery on the irradiated (right) side was detected, accompanied by severe coronary artery stenosis and calcification. Following multidisciplinary evaluation and percutaneous coronary intervention, his symptoms improved significantly, and he was discharged for follow-up. • Rare case of severe carotid (70%–99%) and coronary (90%) stenosis following parotid radiotherapy. • Shockwave balloon angioplasty was used to treat severe coronary calcification with symptomatic improvement. • Illustrates potential mechanisms of radiotherapy-related cardiovascular injury. • Highlights the importance of cardiovascular risk assessment and multidisciplinary management in patients receiving radiotherapy.