Twenty-two years after an obvious radical mastectomy with axillary lymph node dissection
and postoperative conventional radiotherapy for carcinoma of the night breast, an
80-year-old lady was admitted because of the third bleeding episode within one year
originating from the axilla. An aneurysm from the axillary artery was identified as
the source of hemorrhage. Since the sites of irradiation had to be avoided, an extra-anatomic
reversed saphenous vein graft was run from the right common carotid to the brachial
artery. In the same session the bleeding was finally controlled by therapeutic embolization
of the aneurysm using Gianturco- Anderson-Wallace coils. The postoperative angiogram
showed the patent graft. Bleeding did not reoccur during the followup period of 17
months.
Therapeutic embolization - Extra-anatomic carotido-brachial bypass - Interventional
radiology - Irradiation injury
