Endovascular Management of Radiotherapy-Induced Injury to Brachiocephalic Artery Using Covered Stents
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...
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| Veröffentlicht in: | Annals of vascular surgery 2014-04, Vol.28 (3), p.741.e15-741.e18 |
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| container_title | Annals of vascular surgery |
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| creator | Cenizo, Noelia Maria Gonzalez-Fajardo, Jose A Ibanez, Maria A Gastambide, Victoria Martin-Pedrosa, Miguel Gutierrez, Vicente Taylor, James Vaquero, Carlos |
| description | 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. |
| doi_str_mv | 10.1016/j.avsg.2013.10.004 |
| format | Article |
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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.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1016/j.avsg.2013.10.004</identifier><identifier>PMID: 24321265</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>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 ; Surgery ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Vascular System Injuries - diagnosis ; Vascular System Injuries - etiology ; Vascular System Injuries - therapy</subject><ispartof>Annals of vascular surgery, 2014-04, Vol.28 (3), p.741.e15-741.e18</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-5852e73742bdd10ebf0b77dfa5867f0315097ecf7094783d9a00c6ce498b50213</citedby><cites>FETCH-LOGICAL-c411t-5852e73742bdd10ebf0b77dfa5867f0315097ecf7094783d9a00c6ce498b50213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.avsg.2013.10.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24321265$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cenizo, Noelia Maria</creatorcontrib><creatorcontrib>Gonzalez-Fajardo, Jose A</creatorcontrib><creatorcontrib>Ibanez, Maria A</creatorcontrib><creatorcontrib>Gastambide, Victoria</creatorcontrib><creatorcontrib>Martin-Pedrosa, Miguel</creatorcontrib><creatorcontrib>Gutierrez, Vicente</creatorcontrib><creatorcontrib>Taylor, James</creatorcontrib><creatorcontrib>Vaquero, Carlos</creatorcontrib><title>Endovascular Management of Radiotherapy-Induced Injury to Brachiocephalic Artery Using Covered Stents</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>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.</description><subject>Aged</subject><subject>Aneurysm, False - diagnosis</subject><subject>Aneurysm, False - etiology</subject><subject>Aneurysm, False - therapy</subject><subject>Brachiocephalic Trunk - diagnostic imaging</subject><subject>Brachiocephalic Trunk - injuries</subject><subject>Brachiocephalic Trunk - radiation effects</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Humans</subject><subject>Mediastinitis - microbiology</subject><subject>Necrosis</subject><subject>Patient Selection</subject><subject>Prosthesis Design</subject><subject>Radiation Injuries - diagnosis</subject><subject>Radiation Injuries - etiology</subject><subject>Radiation Injuries - therapy</subject><subject>Radiotherapy - adverse effects</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><subject>Vascular System Injuries - diagnosis</subject><subject>Vascular System Injuries - etiology</subject><subject>Vascular System Injuries - therapy</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUGP0zAQhS0EYsvCH-CAcuSSMrbjOJEQ0lItUGkREsueLceetA6pXeykUv89jrpw4MBppJn3nvS-IeQ1hTUFWr8b1vqUdmsGlOfFGqB6Qla0pqIUbSWfkhU0LZQC2vqKvEhpAKCsqZrn5IpVnFFWixXBW2_DSSczjzoWX7XXOzygn4rQF9-1dWHaY9THc7n1djZoi60f5nguplB8jNrsXTB43OvRmeImTpgvD8n5XbEJJ4xZfj_lsPSSPOv1mPDV47wmD59uf2y-lHffPm83N3elqSidStEIhpLLinXWUsCuh05K22vR1LIHTnMXiaaXkPs13LYawNQGq7bpBDDKr8nbS-4xhl8zpkkdXDI4jtpjmJOigoKkvG5FlrKL1MSQUsReHaM76HhWFNSCVw1qwasWvMsu482mN4_5c3dA-9fyh2cWvL8IMLc8OYwqGYc-g3MRzaRscP_P__CP3YzOO6PHn3jGNIQ5-sxPUZWYAnW_PHj5L-UANW9a_hvY26DR</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Cenizo, Noelia Maria</creator><creator>Gonzalez-Fajardo, Jose A</creator><creator>Ibanez, Maria A</creator><creator>Gastambide, Victoria</creator><creator>Martin-Pedrosa, Miguel</creator><creator>Gutierrez, Vicente</creator><creator>Taylor, James</creator><creator>Vaquero, Carlos</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140401</creationdate><title>Endovascular Management of Radiotherapy-Induced Injury to Brachiocephalic Artery Using Covered Stents</title><author>Cenizo, Noelia Maria ; Gonzalez-Fajardo, Jose A ; Ibanez, Maria A ; Gastambide, Victoria ; Martin-Pedrosa, Miguel ; Gutierrez, Vicente ; Taylor, James ; Vaquero, Carlos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-5852e73742bdd10ebf0b77dfa5867f0315097ecf7094783d9a00c6ce498b50213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aneurysm, False - diagnosis</topic><topic>Aneurysm, False - etiology</topic><topic>Aneurysm, False - therapy</topic><topic>Brachiocephalic Trunk - diagnostic imaging</topic><topic>Brachiocephalic Trunk - injuries</topic><topic>Brachiocephalic Trunk - radiation effects</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - instrumentation</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Humans</topic><topic>Mediastinitis - microbiology</topic><topic>Necrosis</topic><topic>Patient Selection</topic><topic>Prosthesis Design</topic><topic>Radiation Injuries - diagnosis</topic><topic>Radiation Injuries - etiology</topic><topic>Radiation Injuries - therapy</topic><topic>Radiotherapy - adverse effects</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><topic>Vascular System Injuries - diagnosis</topic><topic>Vascular System Injuries - etiology</topic><topic>Vascular System Injuries - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cenizo, Noelia Maria</creatorcontrib><creatorcontrib>Gonzalez-Fajardo, Jose A</creatorcontrib><creatorcontrib>Ibanez, Maria A</creatorcontrib><creatorcontrib>Gastambide, Victoria</creatorcontrib><creatorcontrib>Martin-Pedrosa, Miguel</creatorcontrib><creatorcontrib>Gutierrez, Vicente</creatorcontrib><creatorcontrib>Taylor, James</creatorcontrib><creatorcontrib>Vaquero, Carlos</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cenizo, Noelia Maria</au><au>Gonzalez-Fajardo, Jose A</au><au>Ibanez, Maria A</au><au>Gastambide, Victoria</au><au>Martin-Pedrosa, Miguel</au><au>Gutierrez, Vicente</au><au>Taylor, James</au><au>Vaquero, Carlos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endovascular Management of Radiotherapy-Induced Injury to Brachiocephalic Artery Using Covered Stents</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>28</volume><issue>3</issue><spage>741.e15</spage><epage>741.e18</epage><pages>741.e15-741.e18</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><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.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>24321265</pmid><doi>10.1016/j.avsg.2013.10.004</doi></addata></record> |
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| subjects | 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 Surgery Time Factors Tomography, X-Ray Computed Treatment Outcome Vascular System Injuries - diagnosis Vascular System Injuries - etiology Vascular System Injuries - therapy |
| title | Endovascular Management of Radiotherapy-Induced Injury to Brachiocephalic Artery Using Covered Stents |
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