title: Endovascular management of radiotherapy-induced injury to brachiocephalic artery using covered stents.
abstract: Actinic vascular lesions tend to be stenotic-occlusive lesions. In this article, we present 2 exceptional cases of pseudoaneurysms caused by radionecrosis of the supra-aortic trunks. Both patients were treated by a retrograde carotid approach and deployment of a self-expanding covered stent. Proper exclusion of the pseudoaneurysm was attained in both cases; the first patient remained asymptomatic 12 months later; the second patient died of mediastinitis. Compared with conventional surgery, endovascular management is a viable, less invasive alternative in select patients, especially in life-threatening cases.
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain. Electronic address: noecen@yahoo.es.
authors: Noelia Maria
authors: NM
authors: Cenizo
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Jose A
authors: JA
authors: Gonzalez-Fajardo
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Maria A
authors: MA
authors: Ibanez
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Victoria
authors: V
authors: Gastambide
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Miguel
authors: M
authors: Martin-Pedrosa
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Vicente
authors: V
authors: Gutierrez
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: James
authors: J
authors: Taylor
authors: Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Carlos
authors: C
authors: Vaquero
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000293:injuries / Q000528:radiation effects; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008480:Mediastinitis / Q000382:microbiology; D009336:Necrosis; D018579:Patient Selection; D011474:Prosthesis Design; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*