[Natural and corrected history of obliterative radiation arteritis. Apropos of 14 case reports].

Abstract

Analysis of a series of 14 cases of obliterative radiation arteriopathy was carried out in order to study the clinical features, symptomatology and the results of appropriate therapy. This demonstrated that the diagnosis is often missed due to the time interval since radiation and that on the contrary the diagnosis should only be considered in precise circumstances in terms of the delay and localisation superimposed on the irradiated zone with respect of other non-irradiated zones. Diagnosis requires double investigation both in terms of the arterial disease and associated post-radiation lesions and also in terms of the malignant disease, its progression and treatment. Arterial surgery is fraught with difficulty due to sclerosis and other specific problems: skin closure problems, and in the case of a prosthesis, anastomotic breakdown and superinfection. These dangers should not be underestimated even if in the series presented there were no serious postoperative complications. The indication for surgery should therefore be carefully considered: best avoided in asymptomatic forms, dilatation for short lesions and revascularisation for widespread and symptomatic lesions, while choosing the most appropriate revascularisation procedure. Radiation arteritis should be better understood by radiotherapists who should pay attention to preventive measures and advise systematic screening after three years.