Surgery treatment for early radiation ulcer developed after endovascular intervention

Delayed radiation damage to soft tissue and its treatment are described in detail. In the majority of cases the development of late radiation injuries were resulted from the radiation therapy of cancer. Early radiation injuries rarely occur. Most of early radiation-induced pathologic changes result from occupational radiation exposure or violation of radiation safety regulations. Nowadays we witness widespread clinical use of endovascular interventions, that can last for many hours. Concurrently, publications of research groups reported on complications in patients underwent endovascular procedures have appeared. The reported complications can be a result of increasing radiation dose to normal tissue over dose tolerance limits. The article presents a case of the successful treatment of early radiation ulcer on the left shoulder blade developed as a result of coronography followed by transluminal balloon angioplasty and stenting of the ramus interventricularis anterior (RIVA). Fibrotic tissue and radiation ulcer were excised en bloc with a cuff of healthy tissue followed by single-stage plasty with interpolated thoracodorsal musculocutaneous flap. Due to the given treatment we managed to restore the patient’s health status and improve his quality of life.