+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Radiation-induced complications in endovascular neurosurgery: incidence of skin effects and the feasibility of estimating risk of future tumor formation

Radiation-induced complications in endovascular neurosurgery: incidence of skin effects and the feasibility of estimating risk of future tumor formation

Neurosurgery 72(4): 566-572

The incidence of radiation-induced complications is increasingly part of the informed consent process for patients undergoing neuroendovascular procedures. Data guiding these discussions in the era of modern radiation-minimizing equipment is lacking. To quantify the rates of skin and hair effects at a modern high-volume neurovascular center, and to assess the feasibility of accurately quantifying the risk of future central nervous system (CNS) tumor formation. We reviewed a prospectively collected database of endovascular procedures performed at our institution in 2008. The entrance skin dose and brain dose were calculated. Patients receiving skin doses >2 Gy were contacted to inquire about skin and hair changes. We reviewed several recent publications from leading radiation physics bodies to evaluate the feasibility of accurately predicting future cancer risk from neurointerventional procedures. Seven hundred two procedures were included in the study. Of the patients receiving >2 Gy, 39.6% reported subacute skin or hair changes following their procedure, of which 30% were permanent. Increasing skin dose was significantly associated with permanent hair loss. We found substantial methodological difficulties in attempting to model the risk of future CNS tumor formation given the gaps in our current understanding of the brain's susceptibility to low-dose ionizing radiation. Radiation exposures exceeding 2 Gy are common in interventional neuroradiology despite modern radiation-minimizing technology. The incidence of side effects approaches 40%, although the majority is self-limiting. Gaps in current models of brain tumor formation after exposure to radiation preclude accurately quantifying the risk of future CNS tumor formation.

(PDF emailed within 0-6 h: $19.90)

Accession: 055345135

Download citation: RISBibTeXText

PMID: 23269458

DOI: 10.1227/NEU.0b013e318283c9a5

Related references

Radiation induced tumor incidence in anagen phase rat skin. Radiation Research 51(2): 493, 1972

Estimating risk associated with radiation exposure during follow-up after endovascular aortic repair (EVAR). Journal of Cardiovascular Surgery 51(1): 95-104, 2010

The effect of penetration depth on radiation induced tumor formation in the skin of the albino rat. Dissertation Abstracts B Sciences & Engineering 29(1): 53-B, 1968

Radiation-induced hair-follicle damage and tumor formation in mouse and rat skin. Journal of the National Cancer Institute 49(4): 1131-1137, 1972

Future direction of endovascular neurosurgery. No Shinkei Geka. Neurological Surgery 34(1): 7-15, 2006

Incidence and risk factors of vascular complications following endovascular treatment of peripheral arterial disease via the popliteal artery. Cardiovascular Intervention and Therapeutics 26(3): 209-214, 2011

Radiation-induced DNA damage in tumors and normal tissues: I. Feasibility of estimating the hypoxic fraction. Radiation Research 136(1): 77-88, 1993

Complications in Endovascular Neurosurgery: Critical Analysis and Classification. World Neurosurgery 95(): 1-8, 2016

Endovascular neurosurgery in Europe and in Italy: what is in the future?. World Neurosurgery 77(2): 248-251, 2012

Radiation-induced skin injury after complex endovascular procedures. Journal of Vascular Surgery 60(3): 742-748, 2014

Current status and future prospect of endovascular neurosurgery. Journal of Korean Neurosurgical Society 43(2): 69-78, 2008

Endovascular Neurosurgery: Personal Experience and Future Perspectives. World Neurosurgery 93(): 413-420, 2016

The radiation-induced carotid stenosis: preoperative and late complications of surgical and endovascular treatment. Journal of Cardiovascular Surgery (): -, 2015

Clinico-anatomic analysis of complications of endovascular procedures in vascular neurosurgery. Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko: 12-17, 1982