Surgical Treatment for Suspected Radiation Arteritis with Critical Limb Ischemia

Abstract

Radiation arteritis (RA) is known as a late complication of radiotherapy, but it is difficult to diagnose and is often treated as a classical atherosclerotic disease. Revascularization in RA is more difficult than other atherosclerotic diseases, and it is important to keep this possibility in mind when RA is suspected. Herein, we report the successful outcome of revascularization of a critical limb ischemia due to RA using a modified bypass route. A 77-year-old man who received irradiation for right iliac lymph node area at the age of 69, presented with skin ulcers on the right heel and knee. Occlusion was found from the right external iliac to common femoral arteries, coinciding with the irradiation area. Suspecting RA, we performed right axillary-right shallow femoral artery bypass surgery. The route was devised to pass through the superior border of the iliac crest and bypass the right inguinal region. The skin ulcers healed quickly after the surgery, and the postoperative course was uneventful.