Radiation-induced arterial injuries.
Radiation-induced arterial injuries.
复制标题
辐射引起的动脉损伤。
作者：
R. A. McCready;G. Hyde;B. Bivins;S. Mattingly;W. O. Griffen
从1961年到1981年的20年间，在肯塔基州大学医学中心，有20名患者的血管病变直接归因于辐射。两种不同的模式动脉损伤归因于放疗被确定-动脉中断和闭塞。12例患者发生动脉破裂-11例颈动脉爆裂和1例髂动脉破裂。两名患者因即将破裂而接受预防性颈动脉结扎。在11例颈动脉破裂中，9例患者的动脉结扎导致5例患者中风或死亡。髂动脉破裂需要结扎，最终导致严重缺血，需要髋关节离断。6例患者在照射后7 ~ 24年发生异常动脉狭窄或闭塞。3例患者颈总动脉、颈内动脉或颈外动脉严重狭窄或闭塞，导致脑血管功能不全。另外3例髂股区域局灶性狭窄的患者成功接受了旁路移植术。
In a 20-year period from 1961 to 1981 at the University of Kentucky Medical Center, there were 20 patients with vascular lesions directly attributable to irradiation. Two distinct patterns of arterial injury attributable to radiotherapy were identified--arterial disruption and occlusion. Arterial disruption occurred in 12 patients--11 carotid blowouts and 1 iliac artery rupture. Two patients underwent prophylactic carotid artery ligation for impending rupture. In the 11 carotid artery ruptures, ligation of the artery in nine patients resulted in stroke or death in five patients. Iliac artery disruption necessitated ligation, which eventually led to severe ischemia requiring hip disarticulation. Unusual arterial stenosis or occlusion occurred in six patients 7 to 24 years after irradiation. Three patients had severe stenosis or occlusion of the common, internal, or external carotid arteries leading to cerebrovascular insufficiency. Three other patients with focal stenosis of the iliofemoral region were successfully treated with bypass grafting.