Endovascular management of radiotherapy-induced injury to brachiocephalic artery using covered stents

Ann Vasc Surg. 2014 Apr;28(3):741.e15-8. doi: 10.1016/j.avsg.2013.10.004. Epub 2013 Dec 7.

Abstract

Actinic vascular lesions tend to be stenotic-occlusive lesions. In this article, we present 2 exceptional cases of pseudoaneurysms caused by radionecrosis of the supra-aortic trunks. Both patients were treated by a retrograde carotid approach and deployment of a self-expanding covered stent. Proper exclusion of the pseudoaneurysm was attained in both cases; the first patient remained asymptomatic 12 months later; the second patient died of mediastinitis. Compared with conventional surgery, endovascular management is a viable, less invasive alternative in select patients, especially in life-threatening cases.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, False / diagnosis
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy*
  • Brachiocephalic Trunk* / diagnostic imaging
  • Brachiocephalic Trunk* / injuries
  • Brachiocephalic Trunk* / radiation effects
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Fatal Outcome
  • Female
  • Humans
  • Mediastinitis / microbiology
  • Necrosis
  • Patient Selection
  • Prosthesis Design
  • Radiation Injuries / diagnosis
  • Radiation Injuries / etiology
  • Radiation Injuries / therapy*
  • Radiotherapy / adverse effects
  • Risk Factors
  • Stents*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular System Injuries / diagnosis
  • Vascular System Injuries / etiology
  • Vascular System Injuries / therapy*