Ionizing radiation causes obliterative fibrosis and increased wall thickness in irradiated blood vessels, posing unique surgical challenges for microsurgical anastomotic outcomes.
This review highlights the mechanisms of radiation-induced vascular injury and its clinical impact on microsurgical outcomes, emphasizing the need for mitigating therapeutic strategies.
ABSTRACT: The number of cancer survivors continues to increase because of advances in therapeutic modalities. Along with surgery and chemotherapy, radiotherapy is a commonly used treatment modality in roughly half of all cancer patients. It is particularly helpful in the oncologic treatment of patients with breast, head and neck, and prostate malignancies. Unfortunately, among patients receiving radiation therapy, long-term sequalae are often unavoidable, and there is accumulating clinical evidence suggesting significant radiation-related damage to the vascular endothelium. Ionizing radiation has been known to cause obliterative fibrosis and increased wall thickness in irradiated blood vessels. Clinically, these vascular changes induced by ionizing radiation can pose unique surgical challenges when operating in radiated fields. Here, we review the relevant literature on radiation-induced vascular damage focusing on mechanisms and signaling pathways involved and highlight microsurgical anastomotic outcomes after radiotherapy. In addition, we briefly comment on potential therapeutic strategies, which may have the ability to mitigate radiation injury to the vascular endothelium.
Kameni et al. (Sat,) conducted a review in Radiation-induced vascular damage. Ionizing radiation was evaluated. Ionizing radiation causes obliterative fibrosis and increased wall thickness in irradiated blood vessels, posing unique surgical challenges for microsurgical anastomotic outcomes.