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Prolonged Success With a Covered Endovascular Stent After Emergent Use in Radiation-Induced Subclavian Artery Blowout: A Case Report

Department of Surgery at St Louis University School of Medicine, Division of Plastic and Reconstructive Surgery

Catherine M. Wittgen, MD

Division of Vascular Surgery, St Louis, Missouri

Christian E. Paletta, MD

Department of Surgery at St Louis University School of Medicine, Division of Plastic and Reconstructive Surgery, Saint Mary's Health Center St Louis, Missouri, paletta{at}slu.edu

Radiation-induced damage to the bone, soft tissues, and vasculature represents the unfortunate consequences of radiation therapy for the treatment of malignant tumors. Complications arising from irradiation are frequently challenging to manage and may be life threatening. A case is presented of a patient with a longstanding clavicular osteoradionecrosis with an acute massive hemorrhage after rupture of the subclavian artery and subsequent management with endovascular stent placement. With over 2 years' follow-up, vascular patency was maintained with no further bleeding episodes in this surgically high-risk patient.

Key Words: subclavian artery blowout • sentinel bleed • endovascular stent • radiation complications

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