Document Detail


Late complications of revascularization for radiation-induced arterial disease.
MedLine Citation:
PMID:  1460719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During a 14-year period 23 patients underwent 25 revascularizations for radiation-induced arterial obstructive disease. An average of 5000 rads was delivered, 3 to 24 (mean 9) years before arterial insufficiency, for malignancies of the following origin: gynecologic (n = 9), lymphoma (n = 7), head and neck (n = 5), testicular (n = 1), and lower extremity sarcoma (n = 1). Arterial occlusive disease occurred in the aortic arch vessels (n = 8), visceral aortic vessels (n = 1), and aortofemoral vessels (n = 16). Presenting symptoms were claudication (n = 8), rest pain or nonhealing ulcers (n = 7), transient ischemic attacks (n = 6), asymptomatic bruit (n = 1), and renal insufficiency (n = 1). Reconstructive operations included anatomic bypass (n = 10), extra-anatomic bypass (n = 4), patch angioplasty (n = 5), endarterectomy (n = 3), and resection with interposition graft (n = 1). In this group of patients there were no major perioperative wound complications or other major radiation-associated morbidity. Five patients had late graft infections that manifested from 2 to 5 years after surgery. All occurred in anatomic regions where the bypass graft passed through previously irradiated tissues. Presenting symptoms of infection included a draining groin sinus (n = 3) or soft tissue abscess (n = 2). In all cases the graft had not incorporated into the surrounding tissues when passing through the irradiated area. Treatment included graft excision and extra-anatomic bypass through nonirradiated tissue. One patient died of systemic sepsis. Vascular reconstructive surgery can safely be performed for radiation-induced arterial disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
G R Phillips; R M Peer; J F Upson; J J Ricotta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  16     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-01-08     Completed Date:  1993-01-08     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  921-4; discussion 924-5     Citation Subset:  IM    
Affiliation:
University of Pennsylvania Medical Center, Philadelphia.
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MeSH Terms
Descriptor/Qualifier:
Arterial Occlusive Diseases / etiology*,  surgery*
Arteriovenous Shunt, Surgical / adverse effects*
Blood Vessel Prosthesis / adverse effects*
Female
Humans
Incidence
Male
Middle Aged
Prosthesis-Related Infections / epidemiology*
Radiation Injuries / surgery*
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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