Iatrogenic deep musculocutaneous radiation injury following percutaneous coronary intervention.
Radiation-induced skin injury has been reported for multiple fluoroscopic procedures. Previous studies have indicated that prolonged fluoroscopic exposure during even a single percutaneous coronary intervention (PCI) may lead to cutaneous radiation injury. We document a novel case of deep muscle damage requiring wide local debridement and muscle flap reconstruction in a 59-year-old man with a large radiation-induced wound to the lower thoracic region following 1 prolonged PCI procedure. The deep muscular iatrogenic injury described in this report may be the source of significant morbidity. Recommendations to reduce radiation-induced damage include careful examination of the skin site before each procedure, minimized fluoroscopy time, utilization of pulse fluoroscopy, employment of radiation filters, and collimator s and rotation of the location of the image intensifier.
Monaco
JoAn L
JL
Medical Director, Pediatric Plastic Surgery, Children s Hospital Central California, 9300 Valley Children s Place, Madera, CA, 93638-8762, USA. pwitt@childrenscentralcal.org
Bowen
Kanika
K
Tadros
Peter N
PN
Witt
Peter D
PD
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy; D005471:Fluoroscopy / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000528:radiation effects*; D011183:Postoperative Complications / Q000209:etiology; D011832:Radiation Injuries / Q000209:etiology*; D012867:Skin / Q000528:radiation effects*; D012883:Skin Ulcer / Q000209:etiology