Page 23 - Virtual Vascular Vol 6
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Radiation induced Femoral occlusion
Inguinal ligament
divided
EIA
PFA
SFA
A 50 year old lady had wide excision of a nerve sheath tumor in her left thigh 40 years ago, In view of the short and heavily calcified lesion, and its location in the groin, open surgery is
followed by external radiotherapy. She developed an accelerated atherosclerotic occlusion of the best option. She was treated by an open endarterectomy of the left external iliac to com-
a short segment of her left common femoral artery, likely induced by the radiation (damage to mon femoral to superficial femoral artery and repair effected with a vein patch (from the R
the vasa vasorum and fibrosis). She complained of severe claudication and resting pain. This long saphenous vein). The additional risk for this surgery is the radiation induced fibrosis mak-
CT angiogram showed a short, very calcified occluding plaque in the LEIA-CFA region just above ing dissection and identification of the arteries difficult, adherent endarterectomy plane, and
the common femoral bifurcation reduced wound healing potential. The use of vein patch is to reduce risks of infection and the
risk of restenosis.
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