Delayed Common Femoral Artery Rupture Following Irradiation Therapy for Carcinoma of the Vulva

Pararajasingam, Ravi; Todd, Jonathan; Oshodi, Timi

doi:10.1053/ejvs.2001.1510

Cited by 8 publications

(4 citation statements)

References 2 publications

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“…This pathology has been mainly described for the head and neck region as ‘carotid artery blowout syndrome’ . Besides the carotid artery, an increasing number of cases involving other large arteries, like the aorta or the femoral artery, have been reported . Radiotherapy can lead to morphological changes in the arterial wall as a result of inflammation and necrosis, which consequently make it very fragile.…”

Section: Discussionmentioning

confidence: 99%

Management of extremely hard‐to‐heal extremity wounds with severe life‐threatening complications

Cai

Boos

Arkudas

et al. 2016

International Wound Journal

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The introduction of neoadjuvant radiotherapy has allowed limb-preserving surgical treatment in patients with extremity soft tissue sarcoma, and the overall prognosis of this approach is similar to that of limb amputation. The benefits of this treatment, however, are often accompanied with a higher risk of major complications and blood vessel damage because of radiation-induced inflammation and necrosis of the vessel wall. In particular, it is associated with the rupture of large vessels like the femoral artery and more severe complications of wounds located in the proximal lower extremity. We present a series of four patients with soft tissue sarcoma of the thigh undergoing tumour removal and reconstruction of the defect after neoadjuvant radiotherapy. The post-operative outcome depended on the total dose of radiation used as well as the closing technique of the resulting wound. Major wound complications occurred when the irradiated skin was closed directly over the resection cavity or when local skin flaps were used. In one case, severe radiation-induced life-threatening multiple bleeding events occurred, which led to multiple flap failures. Even if the skin cover is not a problem, we propose a combined interdisciplinary approach involving immediate plastic surgical transfer of healthy, well-vascularised tissue into a defect resulting from oncological resection of sarcoma of the lower extremity following neoadjuvant radiotherapy in order to avoid secondary wound breakdown and severe bleeding complications.

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Section: Discussionmentioning

confidence: 99%

Management of extremely hard‐to‐heal extremity wounds with severe life‐threatening complications

Cai

Boos

Arkudas

et al. 2016

International Wound Journal

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show abstract

“…Usually an exsanguinating hemorrhage is preceded by cryptic bleeds. 3 To our knowledge, very few articles report an endovascular management of the SFA rupture 1,4,5 and the RI rupture itself is an extremely rare entity. In fact, the patient had a stage II vulvar carcinoma and the indication for pelvic and inguinal lymph nodes radiotherapy can be questioned in this setting where no positive lymph nodes were identified on pelvic dissection.…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Rupture of the Superficial Femoral Artery: A Case Report

Dahdah

Farha

Karam

et al. 2015

Annals of Vascular Surgery

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“…One patient had a successful graft bypass from the external iliac artery to the superficial femoral artery by tunnelling the graft laterally to the open wound. 1 No follow-up was documented. The other patient had an initial repair of the bleeding superficial femoral artery with 4-0 prolene and subsequently, as the leg became ischaemic, a graft bypass from the external iliac artery to the distal superficial femoral artery.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] We report the first such case where the severe bleeding was managed successfully with immediate surgery followed by endovascular stent graft placement.…”

Section: Introductionmentioning

confidence: 99%

Combined open surgical and endovascular management of ruptured femoral artery from recurrent vulvar cancer

2010

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We report on the case of a 50-year-old woman with exsanguinating haemorrhage from the common femoral artery as a complication of recurrent vulvar cancer in the groin which was managed successfully with combined open surgical and endovascular intervention. She survived another three months and died from progressive disease without further episodes of bleeding. This complication is rare, presents dramatically, and is usually a terminal event. For those cases where intervention is considered appropriate, the option of combined open surgical and endovascular repair should be kept in mind.

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Delayed Common Femoral Artery Rupture Following Irradiation Therapy for Carcinoma of the Vulva

Cited by 8 publications

References 2 publications

Management of extremely hard‐to‐heal extremity wounds with severe life‐threatening complications

Management of extremely hard‐to‐heal extremity wounds with severe life‐threatening complications

Radiation-Induced Rupture of the Superficial Femoral Artery: A Case Report

Combined open surgical and endovascular management of ruptured femoral artery from recurrent vulvar cancer

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