1/3. arteritis and brachial plexus neuropathy as delayed complications of radiation therapy.radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Arteriography revealed arteritis, with ulcerated plaque formation at the subclavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. electromyography showed a chronic brachial plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplatelet therapy. The concurrent combination of radiation-induced arteritis and brachial plexopathy is uncommon but should be considered in patients presenting with upper extremity pain or weakness after radiation therapy.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/3. radiation arteritis following treatment for Wilms' tumor: an unusual case of weight loss.Wilms' tumor is the most common pediatric primary renal cancer and is highly responsive to surgery and chemotherapy. The role of radiotherapy has evolved in the last three decades from the use of stepwise incremental doses in all patients to the current concept of added radiotherapy in advanced cases or in those with unfavorable pathology. To the authors' knowledge, this is the first case of a young woman with prior history of Wilms' tumor and significant weight loss due to radiation arteritis involving the abdominal vasculature. A 31-year-old woman presented with a history of weight loss and severe malnutrition. An angiogram revealed that the aorta was occluded below the renal artery. The celiac artery and the superior mesenteric artery were occluded at the origin, and large intercostal collaterals reconstituted the pelvic circulation. She was initially treated with total parenteral nutrition (TPN) and underwent an infrarenal aortic bypass surgery. Histopathology of the aorta revealed intimal fibrocalcific thickening and changes consistent with radiation-induced arteritis. Later, she was readmitted with progressive hepatic insufficiency. Despite intensive medical therapy, she died of multi-organ failure.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
3/3. Carotid stenting for symptomatic radiation-induced arteritis complicated by recurrent aneurysm formation.We describe a 56-year-old male who underwent successful carotid stenting (CS) with adjuvant distal protection in response to symptomatic radiation-induced carotid disease. During the CS procedure, it was incidentally noted that the lesion yield pressure was surprisingly low (2 atm). The patient returned with local symptoms from common carotid aneurysmal dilation at the proximal edge of the stent that was successfully treated with a stent graft. A second aneurysm developed proximal to the stent graft and, based on intravascular ultrasound mapping, he ultimately underwent venous bypass covered by a free-muscle graft. We believe the low lesion yield pressure in this case reflected loss of vessel integrity and it may be prudent to avoid oversizing the stent in such patients.- - - - - - - - - - ranking = 2.5keywords = radiation-induced (Clic here for more details about this article) |