Modrall J Gregory, Sadjadi Javid
Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235, USA.
Semin Vasc Surg. 2003 Sep;16(3):209-14. doi: 10.1016/s0895-7967(03)00026-7.
Radiotherapy (XRT) plays a prominent role in the therapy of a variety of malignancies. Improved survival for malignancies treated with XRT has produced a growing subset of patients who present several years later with arterial occlusive disease in the irradiated field. Establishing a presumptive diagnosis of radiation arteritis (RA) is based on clinical history and the arteriographic appearance of lesions. The lesions of RA often occur in atypical locations with adjacent arterial beds largely spared of atherosclerosis. The indications for intervention for RA do not differ significantly from atherosclerotic arterial lesions. In most cases, RA lesions do not merit treatment unless they become symptomatic. However, asymptomatic carotid artery lesions should be considered for intervention because they are particularly prone to progression and development of neurologic symptoms. Percutaneous and endovascular techniques are viable treatment options for lesions with favorable anatomy. Operative interventions often require extraanatomic approaches and autogenous conduits to optimize outcomes in irradiated fields.
放射治疗（XRT）在多种恶性肿瘤的治疗中发挥着重要作用。接受XRT治疗的恶性肿瘤患者生存率提高，导致越来越多的患者在数年后出现照射野内的动脉闭塞性疾病。基于临床病史和病变的血管造影表现来建立放射性动脉炎（RA）的初步诊断。RA的病变常发生在非典型部位，相邻动脉床基本无动脉粥样硬化。RA的干预指征与动脉粥样硬化性动脉病变没有显著差异。在大多数情况下，除非RA病变出现症状，否则不值得治疗。然而，无症状的颈动脉病变应考虑进行干预，因为它们特别容易进展并出现神经症状。对于解剖结构有利的病变，经皮和血管内技术是可行的治疗选择。手术干预通常需要采用解剖外途径和自体血管来优化照射野的治疗效果。
