J Korean Diabetes > Volume 15(2); 2014 > Article
The Journal of Korean Diabetes 2014;15(2):124-128.
DOI: https://doi.org/10.4093/jkd.2014.15.2.124    Published online June 25, 2014.
당뇨병성 족부질환에 동반된 방사선 유발 말초동맥질환
이원형, 허재준, 여고은, 최영식, 박요한, 권수경
Radiation Induced Peripheral Arterial Disease associated with Diabetes which Initially Considered as Diabetic Foot Disease.
Weon Hyoung Lee, Jae Joon Heo, Go Eun Yeo, Young Sik Choi, Yo Han Park, Su Kyoung Kwon
Department of Internal Medicine, Endocrinology and Metabolism, Kosin University College of Medicine, Busan, Korea. mir316@naver.com
Therapeutic high-dose radiation can induce atherosclerotic changes of affected arteries. Radiation-associated atherosclerotic diseases of coronary, carotid and subclavian arteries have been demonstrated for years in cancer survivors, but peripheral arterial disease (PAD) associated with radiation is rarely reported. PAD is one of the major macrovascular complications of diabetes and is associated with morbidity and increased mortality. We experienced a case of PAD associated with radiation therapy in a 65-year-old diabetic female patient who had undergone cervical cancer treatment 19 years prior. Computed tomographic angiogram showed occlusion and stenosis from common iliac arteries to superficial femoral arteries. However, both infrapopliteal arteries that are commonly involved in diabetes associated PAD were preserved. She was successfully treated with percutaneous angioplasty combined with femoro-femoral bypass operation. Based on the extent and severity of arterial stenosis in this non-smoking diabetic woman who had a history of high-dose radiation to her pelvis, we concluded that atherosclerotic lesions in this patient were caused by high-dose pelvic irradiation and then exacerbated by diabetes. Therefore, special attention should be given to diabetic patients with history of pelvic irradiation with regard to development of atherosclerosis of peripheral arteries, especially in the pelvic area.
Key Words: Peripheral arterial disease, Diabetes mellitus, Radiation, Diabetic foot

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