VASCULAR SCLEROSIS IN THE LATE PERIOD AFTER RADIOTHERAPY: MESENTERIC ANGINA AND STENT APPLICATION

Selvi B., Kaya B., İkizgül Ö., Altınkaynak M.

ECIM-2025 – European Congress of Internal Medicine, Florence, İtalya, 05 Mart 2025, ss.222-223, (Tam Metin Bildiri)

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Basıldığı Şehir: Florence
  • Basıldığı Ülke: İtalya
  • Sayfa Sayıları: ss.222-223
  • İstanbul Üniversitesi Adresli: Evet

Özet

BACKGROUND:With the advances in cancer treatment modalities and increased survival in malignancies, long-term sequelae after radiotherapy (RT) and treatment (CT) have become more frequent. Like carotid stenosis following radiotherapy, mesenteric vascular sclerosis can be seen even in the later periods following western radiotherapy. It has been shown in the clinic that ionizing radiation increases fibrosis in the vascular endothelium and may cause an increase in vessels.
CASE DESCRIPTION:A 62-year-old female patient applied to our clinic with complaints of abdominal pain that developed in the first one or two hours after eating, avoidance of eating due to abdominal pain, and weight loss of more than 15 kilos in the last few years. The patient had a history of chemotherapy, radiotherapy, and subtotal gastrectomy due to stomach cancer 14 years ago. The patient was being monitored under dual antiplatelet agents, clopidogrel and acetylsalicylic acid, due to arterial thrombosis at the time of application.
CLINICAL HYPOTHESIS:In the patient’s abdominal CT angiography imaging; celiac artery, superior mesenteric artery (SMA), inferior mesenteric artery, right renal arteries were occluded. SMA was fed by internal iliac collaterals, but it was insufficient and there were signs of mesenteric ischemia in places in the intestine.
DIAGNOSTIC PATHWAY:Considering all the findings, the patient was evaluated as having radiotherapy-related vascular sclerosis and a stent procedure was performed for SMA thrombosis. From the first day following the procedure, the patient’s angina that developed after oral intake completely regressed.
DISCUSSION AND LEARNING POINTS:In our case, we present the clinical response after vascular stent intervention for vascular sclerosis that persisted even in the late period after radiotherapy treatments to the abdomen and we emphasize the importance of vascular interventional procedures in radiotherapy-related vascular complications.