Percutaneous intervention for radiation damage to axillary arteries

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Oncology

Background:

• Radiation injury to the subclavian and axillary arteries is a rare but serious late complication of radiotherapy.
• Historically, surgical bypass has been the primary treatment for radiation-induced arterial damage.
• Delayed radiation stenosis and occlusion can lead to severe upper limb ischemia.

Purpose of the Study:

• To evaluate the efficacy of endovascular interventions for radiation-induced upper limb arterial disease.
• To present cases of successful percutaneous management of axillary artery stenosis and occlusion.
• To establish percutaneous angioplasty and stenting as a preferred treatment modality.

Main Methods:

• Retrospective review of three patients with upper limb ischemia secondary to axillary radiotherapy.
• Interventions included balloon angioplasty, arterial stent placement, and surgical bypass.
• Assessment of treatment outcomes based on patient symptom resolution and procedural success.

Main Results:

• One patient with axillary artery occlusion failed angioplasty and underwent successful bypass surgery.
• Another patient with axillary artery occlusion was successfully treated with percutaneous arterial stenting.
• A third patient with isolated axillary artery stenosis showed a positive response to balloon angioplasty.
• All three patients remained asymptomatic following their respective treatments.

Conclusions:

• Percutaneous angioplasty and stent placement are effective and appropriate first-choice treatments for delayed radiation stenosis and occlusion causing upper limb ischemia.
• Endovascular techniques offer a less invasive alternative to traditional bypass surgery for managing radiation-induced arterial complications.
• These minimally invasive approaches can lead to successful outcomes and symptom relief in affected patients.