Severe Skin Reactions from Interventional Fluoroscopy: Case Report and Review of the Literature

Abstract

Some patients with certain preexisting health conditions may be at elevated risk for unusually intense radiation-induced skin reactions and late tissue damage from high-dose interventional procedures. The authors present a case report of a patient with mixed connective tissue disease and non-insulin-dependent diabetes mellitus who developed an unusual complication after placement of a transjugular intrahepatic portosystemic shunt. On the basis of a review of the literature, the following experiences may help identify patients at increased risk: previous high-dose procedures, connective tissue disease, diabetes mellitus, and homozygosity for ataxia telangiectasia.

ACCF/AHA/HRS/SCAI Clinical Competence Statement on Physician Knowledge to Optimize Patient Safety and Image Quality in Fluoroscopically Guided Invasive Cardiovascular Procedures

“…6,11 Data suggest that collagen vascular disease (particularly scleroderma, discoid lupus erythematosis, and mixed connective tissue disease), diabetes mellitus, and hyperthyroidism make the patient more susceptible to injury. Patients homozygous for ataxia telangiectasia are known to be more sensitive.…”

Radiation doses and estimated risk from angiographic projections during coronary angiography performed using novel flat detector

“…Radiation doses from PTCA may reach threshold doses of the order of 2 Gy with the ability of inducing deterministic effect and increased stochastic risk 2 , 3 , 4 . Though deterministic effects are not commonly reported from CA procedures, it can elevate the radiation induced risks, with its effective dose ranging from 3–10 mSv 2 , 5 .…”

Assessment of the Relationship Between Waist Circumference as an Anthropometrical Indicator of Central Obesity and Fluoroscopic Exposure Time in Different Gender Patients Who Underwent Radiofrequency Catheter Ablation Due to Antiarrhythmic Drug-Refractory Tachycardia: a Multicenter Study

“…(4,5) , To our knowledge, few studies have examined the correlation between fluoroscopic time and waist circumference in radiofrequency catheter ablation (4,5) . Similar to all ionizing radiation composed of particles that individually carry enough energy to liberate an electron from an atom, fluoroscopy is associated with increased risks such as skin damage, radiation cataract, and radiation-induced cancer (2,(7)(8)(9)(10) . From biological effects of radiation on human body, radiation effects are generally divided into two groups: deterministic effects and stochastic effects.…”