[Surgical therapy of radiation-induced arterial vascular damage]

Late complications following adjuvant or curative radiotherapy become clinically more evident with increasing duration of the observation period. Atherosclerotic disease secondary to radiation therapy is a rare complication. This is a report on 10 such cases requiring reconstructive vascular surgery between 1980 and January 1986. Previous radiotherapy was performed for malignancies in 9 patients and for thyroiditis in one patient. The time interval between radiation and onset of symptoms due to radiation induced atherosclerotic disease was on average 19.5 years (5-37 years). In order to reduce wound and graft infection to a minimum the extra-anatomical position of the graft was preferred. There was no major morbidity nor mortality postoperatively. During the mean follow-up of 22 months (1-63 months) one late graft occlusion was observed. Our results show that vascular reconstruction of radiation induced atherosclerotic disease is possible. Reconstructive surgery is clearly indicated for patients who underwent previous curative therapy for malignant disease.