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Abstract
Radiotherapy (XRT) plays a prominent role in the therapy of a variety of malignancies.
Improved survival for malignancies treated with XRT has produced a growing subset
of patients who present several years later with arterial occlusive disease in the
irradiated field. Establishing a presumptive diagnosis of radiation arteritis (RA)
is based on clinical history and the arteriographic appearance of lesions. The lesions
of RA often occur in atypical locations with adjacent arterial beds largely spared
of atherosclerosis. The indications for intervention for RA do not differ significantly
from atherosclerotic arterial lesions. In most cases, RA lesions do not merit treatment
unless they become symptomatic. However, asymptomatic carotid artery lesions should
be considered for intervention because they are particularly prone to progression
and development of neurologic symptoms. Percutaneous and endovascular techniques are
viable treatment options for lesions with favorable anatomy. Operative interventions
often require extraanatomic approaches and autogenous conduits to optimize outcomes
in irradiated fields.