Aortic Arteriosclerosis in the Dog After Localized Aortic X-lrradiation

Lindsay, Stuart; Kohn, Henry I.; Dakin, Richard L.; Jew, Jack

doi:10.1161/01.res.10.1.51

Cited by 133 publications

(10 citation statements)

References 8 publications

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“…Both survivor groups, those who received lower doses (1,800–3,000 cGy) and those who received higher doses (>3,000 cGy) of radiation, had significantly higher IMT and more plaque deposits than controls. While animal studies have demonstrated a dose response relationship between radiation and vascular injury [28], findings from adult cancer studies have been inconsistent [26,29]. As a result of these inconclusive findings, current recommendations for ultrasound screening of adult patients treated with neck irradiation are not based on radiation exposure, that is, dose [30].…”

Section: Discussionmentioning

confidence: 99%

Premature carotid artery disease in pediatric cancer survivors treated with neck irradiation

Meeske

Siegel

Gilsanz

et al. 2009

Pediatric Blood & Cancer

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Background While carotid artery disease and strokes have been documented in adult cancer patients treated with neck irradiation, little information is available on pediatric patients. The purpose of this study is to determine if carotid disease is more prevalent among pediatric cancer survivors treated with neck irradiation than among healthy controls. Procedure Thirty pediatric cancer survivors who received neck irradiation (2,000–6,660 cGy) and 30 healthy subjects underwent bilateral carotid ultrasounds. Study outcome measures were common carotid intima-media thickness (IMT) and plaque (present or absent). Multivariate methods were used to compare cases and controls and to identify risk factors related to carotid disease in childhood cancer survivors. Results IMT was greater for cancer survivors than controls (0.46mm (SD 0.12) vs. 0.41mm (SD 0.06), P < 0.001). Plaque was present in 18% of irradiated vessels and 2% of non-irradiated vessels (P < 0.01). Among cancer survivors, IMT was positively associated with female gender (P < 0.05), nonwhite ethnicity (P < 0.01), positive family history of stroke/heart attack (P < 0.05), BMI (P < 0.001), total cholesterol (P < 0.01), cancer relapse (P < 0.001), and years off treatment (P < 0.0001). Plaque was positively associated with relapse (P < 0.05) and C-reactive protein (P < 0.01). There was no significant relationship between radiation dose at levels ≥2,000 cGy and IMT or plaque. Conclusions Carotid artery disease was more prevalent among cancer survivors treated with neck irradiation than among controls. Due to the high risk of stroke associated with advanced carotid disease, larger prospective studies are needed to better define disease risk in these long-term survivors.

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Section: Discussionmentioning

confidence: 99%

Premature carotid artery disease in pediatric cancer survivors treated with neck irradiation

Meeske

Siegel

Gilsanz

et al. 2009

Pediatric Blood & Cancer

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“…Radiotherapy is a well-known cause of vascular disease especially when vessels are exposed to radiation doses ranging from 25 to 40 Gy. 17 In our patient, the aortic pseudoaneurysm developed in a region that received a total radiation dose of 53.2 Gy (Figures 3 and 4 B). The metallic stent irradiated that could result in an overdose of 14% to 21% at a depth of 0.5 mm in the esophageal wall.…”

Section: Discussionmentioning

confidence: 60%

Aortic Pseudoaneurysm Formation Following Concurrent Chemoradiotherapy And Metallic Stent Insertion in a Patient With Esophageal Cancer

et al. 2015

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Aortic pseudoaneurysm formation subsequent to concurrent chemoradiotherapy (CCRT) for esophageal cancer patient with esophageal metallic stent insertion is a rare condition.A 52-year-old man with esophageal cancer, cT4N1M0, stage IIIC, was treated with concurrent weekly cisplatin (30 mg/m2) and 5-Fluorouracil (500 mg/m2) as well as radiotherapy (50.4 Gy in 28 fractions) for 6 weeks. An esophageal metallic stent was inserted for dysphagia 1 week after initiation of CCRT. During the treatment regimen, the platelet count dropped to less than 200 × 103 /μL. One month after the completion of CCRT, chest CT revealed the presence of an aortic pseudoaneurysm as well as aortoesophageal fistulas. A thoracic aortic endografting was performed and the patient responded well to surgery. However, the patient died 2 months later due to a nosocomial infection.Multimodality treatment for esophageal cancer comprising cisplatin-based CCRT and esophageal metallic stent placement near a great vessel may increase the risk of pseudoaneurysm formation.

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“…26 Radiation-induced or accelerated atherosclerotic changes in the carotid arteries have been well documented. [10][11][12][13][14][15][16][17] Arterial stenosis was localised to the common carotid artery in our study, and there was no increased incidence of intracranial arterial stenosis. This may be explained by the fact that the intracranial arteries are not directly within the centre of radiation port, and there is bone surrounding the vessels, thus they are not exposed to the same radiation dosage as the extracranial arteries.…”

Section: Discussionmentioning

confidence: 69%

“…Radiation-induced injury either causing or accelerating atherosclerotic changes in the carotid arteries has been well-documented in both experimental animal and human subjects. [8][9][10][11][12][13][14][15][16][17] Thus the possibility of post-irradiation intracranial arterial stenosis due to atherosclerosis is a particular concern. Intracranial atherosclerotic stenosis is a significant risk factor for stroke and is postulated to cause approximately 15% of all ischaemic events.…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy for Nasopharyngeal Carcinoma as a Risk Factor for Extracranial Carotid Stenosis. Is It Also a Risk Factor for Intracranial Arteries? A Retrospective Case-control Study

Chu¹,

Tsang²,

Wong³

et al. 2015

Hong Kong J Radiol

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Objective: Carotid duplex ultrasound has revealed that radiotherapy is associated with stenosis of the extracranial carotid arteries in patients with nasopharyngeal carcinoma (NPC). The objective of the study was to determine the relationship between intracranial and extracranial arterial stenosis and radiation therapy using computed tomographic angiography (CTA) in patients with NPC and a history of symptomatic cerebral ischaemia. Methods: This was a retrospective case-control study conducted in Pok Oi Hospital, Hong Kong. All consecutive CTA scans of the head and neck from January 2008 to December 2009 in patients with a history of transient ischaemic attack or ischaemic stroke were included. Intracranial arterial (including intracranial internal carotid artery, M1 segment of middle cerebral artery, and intracranial vertebral artery) and extracranial arterial stenosis was defined as a diameter reduction of ≥50%. Patient demographics, history of radiotherapy for NPC, smoking history, medical history of diabetes mellitus, hypertension, and hyperlipidaemia were recorded. Results: A total of 152 patients (105 men and 47 women; mean [standard deviation] age, 64.9 [11.6] years) were enroled. Of them, 19 (12.5%) had a history of NPC and treatment by radiotherapy; 133 (87.5%) patients did not receive any head and neck radiotherapy. A statistically significantly increased risk of common carotid artery stenosis (p < 0.001; adjusted odds ratio = 34.510) and extracranial arterial stenosis (p = 0.001; adjusted odds ratio = 6.607) was observed in patients with NPC treated with radiotherapy compared with those without irradiation. Radiotherapy did not increase the risk of intracranial arterial stenosis (10/19 [52.6%] vs. 75/133 [56.4%]; p = 0.710). Conclusion: Radiotherapy for NPC is associated with an increased risk for stenosis of the extracranial arteries, particularly the common carotid artery. Radiotherapy for NPC was not shown to increase the risk of intracranial artery stenosis based on CTA findings in patients with symptomatic cerebral ischaemia.

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Aortic Arteriosclerosis in the Dog After Localized Aortic X-lrradiation

Cited by 133 publications

References 8 publications

Premature carotid artery disease in pediatric cancer survivors treated with neck irradiation

Premature carotid artery disease in pediatric cancer survivors treated with neck irradiation

Aortic Pseudoaneurysm Formation Following Concurrent Chemoradiotherapy And Metallic Stent Insertion in a Patient With Esophageal Cancer

Radiotherapy for Nasopharyngeal Carcinoma as a Risk Factor for Extracranial Carotid Stenosis. Is It Also a Risk Factor for Intracranial Arteries? A Retrospective Case-control Study

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