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The Effect of Radiation on Carotid Arteries: A Review Article

The Effect of Radiation on Carotid Arteries: A Review Article Abstract • The effects of irradiation on blood vessels supplying the brain are reviewed. Short-term and long-term effects on large arteries result in an atheroscleroticlike disorder. The response may have a latency up to 20 years before the onset of symptoms and signs. This delay is probably related to the diameter of the irradiated artery; the interval is longer for larger arteries. However, it is possible that the apparent injury to the large arteries is in fact due to occlusion of the vasa vasorum because the microvasculature is especially vulnerable to radiation damage. References 1. Gassmann A: Zur histologie der rontgenulcera . Fortschr Geb Roentgenstr Nuklearmed Erganzungsband 1899:2199-2207. 2. Gold H: Production of arteriosclerosis in the rat: Effect of x-ray and a high-fat diet . Arch Pathol Lab Med 1961;71:268-273. 3. Lindsay S, Kohn HI, Dakin RL, et al: Aortic arteriosclerosis in the dog after localized aortic x-irradiation . Circ Res 1962;10:51-60.Crossref 4. Lamberts HD, de Boer WGRM: Contributions to the study of immediate and early x-ray reactions with regard to chemoprotection: VII. X-ray-induced atheromatous lesions in the arterial wall of cholesterolemic rabbits . Int J Radiat Biol 1965;9:165-174.Crossref 5. Tiamson E, Anzola E, Fritz K, et al: The effect of low dosage irradiation on rabbit atherosclerosis . Circulation 1968;37( (suppl) ):VI-25. 6. Morrison LM, Bajwa GS, Ershoff BH: Comparison of two new models for induction of atherosclerosis in rats . Circulation 1969;39( (suppl) ):III-18. 7. Konings AWT, Hardonk MJ, Wieringa RA, et al: Initial events in radiation-induced atheromatosis: I. Activation of lysosomal enzymes . Strahlenther Onkol 1975;150:444-448. 8. Konings AWT, Smit Sibinga CT, Lamberts HB: Initial events in radiation-induced atheromatosis . Strahlenther Onkol 1980;156:134-138. 9. Fonkalsrud EW, Sanchez M, Zerubavel R, et al: Serial changes in arterial structure following radiation therapy . Surg Gynecol Obstet 1977;145:395-400. 10. Rubin P, Casarett GW: Clinical Radiation Pathology . Philadelphia, WB Saunders Co, 1968, pp 43-51. 11. Dunjic A: Blood flow and permeability after whole body irradiation . Curr Top Radiat Res 1974;10:170-184. 12. Ackerman LV: The pathology of radiation effect on normal and neoplastic tissue . A J R 1972;114:447-459. 13. Kirkpatrick JB: Pathogenesis of foam cell lesions in irradiated arteries . Am J Pathol 1967;50:291-309. 14. Marcial-Rojas RA, Castro JR: Irradiation injury to elastic arteries in the course of treatment for neoplastic disease . Ann Otol Rhinol Laryngol 1962;71:945-958. 15. Fajardo LF, Lee A: Rupture of major vessels after radiation . Cancer 1978;36:904-913.Crossref 16. Heidenberg WJ, Lupovitch A, Tarr N: 'Pulseless disease' complicating Hodgkin's disease . JAMA 1966;195:194-196.Crossref 17. Rotman M, Seidenberg B, Rubin I, et al: Aortic arch syndrome secondary to radiation in childhood . Arch Intern Med 1969;124:87-90.Crossref 18. Glick B: Bilateral carotid occlusive disease . Arch Pathol Lab Med 1972;93:352-355. 19. Hayward RH: Arteriosclerosis induced by radiation . Surg Clin North Am 1972;52:359-366. 20. Swales DW, Mewett J: Occlusion of the common carotid arteries secondary to radiation therapy. Read before a meeting of the Canadian Association of Radiologists, Toronto, 1972. 21. Levinson SA, Close MB, Ehrenfeld WK, et al: Carotid artery occlusive disease following external cervical irradiation . Arch Surg 1973;107:395-397.Crossref 22. St Louis EL, McLoughlin MJ, Wortzman G: Chronic damage to medium and large arteries following radiation . J Can Assoc Radiol 1974;25:95-104. 23. Bladin PF, Royle J: Post-irradiation extracranial cerebrovascular disease . Clin Exp Neurol 1977;14:8-14. 24. Conomy JP, Kellermeyer R: Delayed cerebrovascular consequences of therapeutic radiation: A clinicopathologic study of a stroke associated with radiation-related carotid arteriopathy . Cancer 1975;36:1702-1708.Crossref 25. Liegel O: Double-sided occlusion of the great vessels of the neck after x-ray treatment in childhood . Klin Monatsbl Augenheilkd 1975;167:704-717. 26. Silverberg GD, Britt RH, Goffinet DR: Radiation-induced carotid artery disease . Cancer 1978;41:130-137.Crossref 27. Eisenberg RL, Hedgcock MW, Wara WM, et al: Radiation-induced disease of the carotid artery . West J Med 1978;129:500-503. 28. McCready RA, Hyde GL, Binins BA, et al: Radiation induced arterial injuries . Surgery 1983;93:306-312. 29. Kearsley JH: Late cerebrovascular disease after radiation therapy: Report of two cases and a review of the literature . Australas Radiol 1983;27:11-18.Crossref 30. Marty AT, Logan JA: Radiation induced amaurosis fugax . Indiana Med 1984;77:90-91. 31. Osgood CP, Karunaratne ER, Sandler R, et al: Carotid occlusion in a 27-year-old man. A case report . Neurosurgery 1986;18:459-460.Crossref 32. Bergqvist D, Jonsson K, Nilsson M, et al: Treatment of arterial lesions after radiation therapy . Surg Gynecol Obstet 1987;165:116-120. 33. Nardelli E, Fiaschi A, Ferrari G: Delayed cerebrovascular consequences of radiation to the neck . Arch Neurol 1978;35:538-540.Crossref 34. Loftus CM, Biller J, Hart MN, et al: Management of radiation-induced accelerated carotid atherosclerosis . Arch Neurol 1987;44:711-714.Crossref 35. Darmody WR, Thomas LM, Gurdjian ES: Postirradiation vascular insufficiency syndrome . Neurology 1967;17:1190-1192.Crossref 36. Lee KF, Hodes PJ: Intracranial ischemic lesions . Radiol Clin North Am 1967;5:363-393. 37. Hilal SK, Solomon GE, Gold AP, et al: Primary cerebral arterial occlusive disease in children . Radiology 1971;99:87-93.Crossref 38. Taveras JM: Multiple progressive intracranial arterial occlusions: A syndrome of children and young adults . AJR 1969;106:235-268.Crossref 39. Debrun G, Sauvegrain J, Aicardi J, et al: Moyamoya, a nonspecific radiological syndrome . Neuroradiology 1975;8:241-244.Crossref 40. Painter MJ, Chutorian AM, Hilal SK: Cerebrovasculopathy following irradiation in childhood . Neurology 1975;25:189-194.Crossref 41. Klatte EC, Franken EA, Smith JA: The radiographic spectrum in neurofibromatosis . Semin Roentgenol 1976;11:17-33.Crossref 42. Wright TL, Bresnan MJ: Radiationinduced cerebrovascular disease in children . Neurology 1976;26:540-543.Crossref 43. Servo A, Puranen M: Moyamoya syndrome as a complication of radiation therapy . J Neurosurg 1978;48:1026-1029.Crossref 44. Mori K, Takeuchi J, Ishikawa M, et al: Occlusive arteriopathy and brain tumor . J Neurosurg 1978;49:22-35.Crossref 45. Rajakulasingam K, Cerullo LJ, Raimondi AJ: Childhood moyamoya syndrome . Pediatr Neurosci 1979;5:467-475.Crossref 46. Brant-Zawadzki M, Anderson M, DeArmond SJ, et al: Radiation-induced large intracranial vessel occlusive vasculopathy . AJR 1980;134:51-55.Crossref 47. Montanera W, Chui M, Hudson A: Meningioma and occlusive vasculopathy: Coexisting complications of past extracranial radiation . Surg Neurol 1985;24:35-39.Crossref 48. Hirata Y, Matsukado Y, Mihara Y, et al: Occlusion of the internal carotid artery after radiation therapy for the chiasmal lesion . Acta Neurochir 1985;74:141-147.Crossref 49. Okuno T, Prensky AL, Gado M: The moyamoya syndrome associated with irradiation of an optic glioma in children: Report of two cases and review of the literature . Pediatr Neurol 1985;1:311-318.Crossref 50. Kagan AR, Bruce DW, Chiro GD: Fatal foam cell arteritis of the brain after irradiation for Hodgkin's disease: Angiography and pathology . Stroke 1971;2:232-238.Crossref 51. Eyster EF, Nielsen SL, Sheline GE, et al: Cerebral radiation necrosis simulating a brain tumor . J Neurosurg 1974;39:267-271.Crossref 52. Haselton PS, Carr N, Schofield PF: Vascular changes in radiation bowel disease . Histopathology 1985;9:517-534.Crossref 53. Queiroz LS, da Cruz Neto JN: Late pseudotumoral brain necrosis following irradiation of a scalp neoplasm . J Neurosurg 1976;45:581-584.Crossref 54. Mettler FA, Moseley RD Jr: Medical Effects of Ionizing Radiation . New York, Grune & Stratton, 1985, p 146. 55. Hekali P, Halttunen P, Korhola O, et al: Occlusion of the right pulmonary artery: A rare left complication of radiation therapy . Ann Clin Res 1982;14:7-10. 56. Tracy GP, Brown DE, Johnson LW, et al: Radiation-induced coronary artery disease . JAMA 1974;228:1660-1662.Crossref 57. Simon EB, Ling J, Mendizabel RC, et al: Radiation-induced coronary artery disease . Am Heart J 1984;108:1032-1034.Crossref 58. Thomas E, Forbus WD: Irradiation injury to the aorta and the lung . Arch Pathol Lab Med 1959;67:256-263. 59. Benson EP: Radiation injury to large arteries . Radiology 1973;106:195-197.Crossref 60. Loeffler RK: Subclavian artery occlusion following radiation therapy . Invest Radiol 1975;10:391-393.Crossref 61. Dencker H, Holmdahl KH, Lunderquist A, et al: Mesenteric angiography in patients with radiation injury of the bowel after pelvis irradiation . AJR 1972;114:476-481.Crossref 62. Lawson JA: Surgical treatment of radiation induced atherosclerotic disease of iliac and femoral arteries . J Cardiovasc Surg 1985;26:151-156. 63. Brosius FC, Waller BF, Roberts WC: Radiation heart disease: Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3500 rad to the heart . Am J Med 1981;70:519-530.Crossref 64. Sheline SE, Wara WM, Smith V: Therapeutic irradiation and brain injury . Rad Oncol Biol Phys 1980;6:1215-1228.Crossref 65. Elerding SC, Fernandez RN, Grotta JC, et al: Carotid artery disease following external cervical irradiation. 66. Stewart AM, Kneale GW: Non-cancer effects of exposure to A-bomb radiation . J Epidemiol Community Health 1984;38:108-112.Crossref 67. Jablon S, Miller RW: Army technologists: 29-year follow up for cause of death . Radiology 1978;126:677-679.Crossref 68. Raman S, Dulberg CS, Spasoff RA, et al: Mortality among Canadian military personnel exposed to low-dose radiation . Can Med Assoc J 1987;136:1051-1056. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

The Effect of Radiation on Carotid Arteries: A Review Article

Archives of Neurology , Volume 46 (4) – Apr 1, 1989

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References (76)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1989.00520400109029
Publisher site
See Article on Publisher Site

Abstract

Abstract • The effects of irradiation on blood vessels supplying the brain are reviewed. Short-term and long-term effects on large arteries result in an atheroscleroticlike disorder. The response may have a latency up to 20 years before the onset of symptoms and signs. This delay is probably related to the diameter of the irradiated artery; the interval is longer for larger arteries. However, it is possible that the apparent injury to the large arteries is in fact due to occlusion of the vasa vasorum because the microvasculature is especially vulnerable to radiation damage. References 1. Gassmann A: Zur histologie der rontgenulcera . Fortschr Geb Roentgenstr Nuklearmed Erganzungsband 1899:2199-2207. 2. Gold H: Production of arteriosclerosis in the rat: Effect of x-ray and a high-fat diet . Arch Pathol Lab Med 1961;71:268-273. 3. Lindsay S, Kohn HI, Dakin RL, et al: Aortic arteriosclerosis in the dog after localized aortic x-irradiation . Circ Res 1962;10:51-60.Crossref 4. Lamberts HD, de Boer WGRM: Contributions to the study of immediate and early x-ray reactions with regard to chemoprotection: VII. X-ray-induced atheromatous lesions in the arterial wall of cholesterolemic rabbits . Int J Radiat Biol 1965;9:165-174.Crossref 5. Tiamson E, Anzola E, Fritz K, et al: The effect of low dosage irradiation on rabbit atherosclerosis . Circulation 1968;37( (suppl) ):VI-25. 6. Morrison LM, Bajwa GS, Ershoff BH: Comparison of two new models for induction of atherosclerosis in rats . Circulation 1969;39( (suppl) ):III-18. 7. Konings AWT, Hardonk MJ, Wieringa RA, et al: Initial events in radiation-induced atheromatosis: I. Activation of lysosomal enzymes . Strahlenther Onkol 1975;150:444-448. 8. Konings AWT, Smit Sibinga CT, Lamberts HB: Initial events in radiation-induced atheromatosis . Strahlenther Onkol 1980;156:134-138. 9. Fonkalsrud EW, Sanchez M, Zerubavel R, et al: Serial changes in arterial structure following radiation therapy . Surg Gynecol Obstet 1977;145:395-400. 10. Rubin P, Casarett GW: Clinical Radiation Pathology . Philadelphia, WB Saunders Co, 1968, pp 43-51. 11. Dunjic A: Blood flow and permeability after whole body irradiation . Curr Top Radiat Res 1974;10:170-184. 12. Ackerman LV: The pathology of radiation effect on normal and neoplastic tissue . A J R 1972;114:447-459. 13. Kirkpatrick JB: Pathogenesis of foam cell lesions in irradiated arteries . Am J Pathol 1967;50:291-309. 14. Marcial-Rojas RA, Castro JR: Irradiation injury to elastic arteries in the course of treatment for neoplastic disease . Ann Otol Rhinol Laryngol 1962;71:945-958. 15. Fajardo LF, Lee A: Rupture of major vessels after radiation . Cancer 1978;36:904-913.Crossref 16. Heidenberg WJ, Lupovitch A, Tarr N: 'Pulseless disease' complicating Hodgkin's disease . JAMA 1966;195:194-196.Crossref 17. Rotman M, Seidenberg B, Rubin I, et al: Aortic arch syndrome secondary to radiation in childhood . Arch Intern Med 1969;124:87-90.Crossref 18. Glick B: Bilateral carotid occlusive disease . Arch Pathol Lab Med 1972;93:352-355. 19. Hayward RH: Arteriosclerosis induced by radiation . Surg Clin North Am 1972;52:359-366. 20. Swales DW, Mewett J: Occlusion of the common carotid arteries secondary to radiation therapy. Read before a meeting of the Canadian Association of Radiologists, Toronto, 1972. 21. Levinson SA, Close MB, Ehrenfeld WK, et al: Carotid artery occlusive disease following external cervical irradiation . Arch Surg 1973;107:395-397.Crossref 22. St Louis EL, McLoughlin MJ, Wortzman G: Chronic damage to medium and large arteries following radiation . J Can Assoc Radiol 1974;25:95-104. 23. Bladin PF, Royle J: Post-irradiation extracranial cerebrovascular disease . Clin Exp Neurol 1977;14:8-14. 24. Conomy JP, Kellermeyer R: Delayed cerebrovascular consequences of therapeutic radiation: A clinicopathologic study of a stroke associated with radiation-related carotid arteriopathy . Cancer 1975;36:1702-1708.Crossref 25. Liegel O: Double-sided occlusion of the great vessels of the neck after x-ray treatment in childhood . Klin Monatsbl Augenheilkd 1975;167:704-717. 26. Silverberg GD, Britt RH, Goffinet DR: Radiation-induced carotid artery disease . Cancer 1978;41:130-137.Crossref 27. Eisenberg RL, Hedgcock MW, Wara WM, et al: Radiation-induced disease of the carotid artery . West J Med 1978;129:500-503. 28. McCready RA, Hyde GL, Binins BA, et al: Radiation induced arterial injuries . Surgery 1983;93:306-312. 29. Kearsley JH: Late cerebrovascular disease after radiation therapy: Report of two cases and a review of the literature . Australas Radiol 1983;27:11-18.Crossref 30. Marty AT, Logan JA: Radiation induced amaurosis fugax . Indiana Med 1984;77:90-91. 31. Osgood CP, Karunaratne ER, Sandler R, et al: Carotid occlusion in a 27-year-old man. A case report . Neurosurgery 1986;18:459-460.Crossref 32. Bergqvist D, Jonsson K, Nilsson M, et al: Treatment of arterial lesions after radiation therapy . Surg Gynecol Obstet 1987;165:116-120. 33. Nardelli E, Fiaschi A, Ferrari G: Delayed cerebrovascular consequences of radiation to the neck . Arch Neurol 1978;35:538-540.Crossref 34. Loftus CM, Biller J, Hart MN, et al: Management of radiation-induced accelerated carotid atherosclerosis . Arch Neurol 1987;44:711-714.Crossref 35. Darmody WR, Thomas LM, Gurdjian ES: Postirradiation vascular insufficiency syndrome . Neurology 1967;17:1190-1192.Crossref 36. Lee KF, Hodes PJ: Intracranial ischemic lesions . Radiol Clin North Am 1967;5:363-393. 37. Hilal SK, Solomon GE, Gold AP, et al: Primary cerebral arterial occlusive disease in children . Radiology 1971;99:87-93.Crossref 38. Taveras JM: Multiple progressive intracranial arterial occlusions: A syndrome of children and young adults . AJR 1969;106:235-268.Crossref 39. Debrun G, Sauvegrain J, Aicardi J, et al: Moyamoya, a nonspecific radiological syndrome . Neuroradiology 1975;8:241-244.Crossref 40. Painter MJ, Chutorian AM, Hilal SK: Cerebrovasculopathy following irradiation in childhood . Neurology 1975;25:189-194.Crossref 41. Klatte EC, Franken EA, Smith JA: The radiographic spectrum in neurofibromatosis . Semin Roentgenol 1976;11:17-33.Crossref 42. Wright TL, Bresnan MJ: Radiationinduced cerebrovascular disease in children . Neurology 1976;26:540-543.Crossref 43. Servo A, Puranen M: Moyamoya syndrome as a complication of radiation therapy . J Neurosurg 1978;48:1026-1029.Crossref 44. Mori K, Takeuchi J, Ishikawa M, et al: Occlusive arteriopathy and brain tumor . J Neurosurg 1978;49:22-35.Crossref 45. Rajakulasingam K, Cerullo LJ, Raimondi AJ: Childhood moyamoya syndrome . Pediatr Neurosci 1979;5:467-475.Crossref 46. Brant-Zawadzki M, Anderson M, DeArmond SJ, et al: Radiation-induced large intracranial vessel occlusive vasculopathy . AJR 1980;134:51-55.Crossref 47. Montanera W, Chui M, Hudson A: Meningioma and occlusive vasculopathy: Coexisting complications of past extracranial radiation . Surg Neurol 1985;24:35-39.Crossref 48. Hirata Y, Matsukado Y, Mihara Y, et al: Occlusion of the internal carotid artery after radiation therapy for the chiasmal lesion . Acta Neurochir 1985;74:141-147.Crossref 49. Okuno T, Prensky AL, Gado M: The moyamoya syndrome associated with irradiation of an optic glioma in children: Report of two cases and review of the literature . Pediatr Neurol 1985;1:311-318.Crossref 50. Kagan AR, Bruce DW, Chiro GD: Fatal foam cell arteritis of the brain after irradiation for Hodgkin's disease: Angiography and pathology . Stroke 1971;2:232-238.Crossref 51. Eyster EF, Nielsen SL, Sheline GE, et al: Cerebral radiation necrosis simulating a brain tumor . J Neurosurg 1974;39:267-271.Crossref 52. Haselton PS, Carr N, Schofield PF: Vascular changes in radiation bowel disease . Histopathology 1985;9:517-534.Crossref 53. Queiroz LS, da Cruz Neto JN: Late pseudotumoral brain necrosis following irradiation of a scalp neoplasm . J Neurosurg 1976;45:581-584.Crossref 54. Mettler FA, Moseley RD Jr: Medical Effects of Ionizing Radiation . New York, Grune & Stratton, 1985, p 146. 55. Hekali P, Halttunen P, Korhola O, et al: Occlusion of the right pulmonary artery: A rare left complication of radiation therapy . Ann Clin Res 1982;14:7-10. 56. Tracy GP, Brown DE, Johnson LW, et al: Radiation-induced coronary artery disease . JAMA 1974;228:1660-1662.Crossref 57. Simon EB, Ling J, Mendizabel RC, et al: Radiation-induced coronary artery disease . Am Heart J 1984;108:1032-1034.Crossref 58. Thomas E, Forbus WD: Irradiation injury to the aorta and the lung . Arch Pathol Lab Med 1959;67:256-263. 59. Benson EP: Radiation injury to large arteries . Radiology 1973;106:195-197.Crossref 60. Loeffler RK: Subclavian artery occlusion following radiation therapy . Invest Radiol 1975;10:391-393.Crossref 61. Dencker H, Holmdahl KH, Lunderquist A, et al: Mesenteric angiography in patients with radiation injury of the bowel after pelvis irradiation . AJR 1972;114:476-481.Crossref 62. Lawson JA: Surgical treatment of radiation induced atherosclerotic disease of iliac and femoral arteries . J Cardiovasc Surg 1985;26:151-156. 63. Brosius FC, Waller BF, Roberts WC: Radiation heart disease: Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3500 rad to the heart . Am J Med 1981;70:519-530.Crossref 64. Sheline SE, Wara WM, Smith V: Therapeutic irradiation and brain injury . Rad Oncol Biol Phys 1980;6:1215-1228.Crossref 65. Elerding SC, Fernandez RN, Grotta JC, et al: Carotid artery disease following external cervical irradiation. 66. Stewart AM, Kneale GW: Non-cancer effects of exposure to A-bomb radiation . J Epidemiol Community Health 1984;38:108-112.Crossref 67. Jablon S, Miller RW: Army technologists: 29-year follow up for cause of death . Radiology 1978;126:677-679.Crossref 68. Raman S, Dulberg CS, Spasoff RA, et al: Mortality among Canadian military personnel exposed to low-dose radiation . Can Med Assoc J 1987;136:1051-1056.

Journal

Archives of NeurologyAmerican Medical Association

Published: Apr 1, 1989

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