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Fluoroscopic radiation is a carcinogen that can also cause severe injury (“radiation burns”) in patients and practitioners. Figures 11-1,11-2,11-3,11-4 illustrate the severe effects of radiation. All effects pictured were caused by radiation associated with fluoroscopy. Note the characteristic demarcation of injuries with sharp borders, a feature usually but not always associated with severe radiation effects from fluoroscopy.
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Figure 11-11 is a breast cancer caused by fluoroscopically guided interventional procedures performed to cure pulmonary tuberculosis in the mid-20th century. Chronic radiation dermatitis is also readily apparent in this picture, taken in the 1960s approximately 10 to 15 years after exposure to the radiation.
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Figure 11-2 shows a deep necrotic wound following 2 ablation procedures 6 and 10 months previously. The ribs underlying the wound necrosed at about 4 years after the procedure. Advances in cardiac mapping during electrophysiologic procedures have mitigated the need for long-duration fluoroscopy and have reduced the likelihood of such effects in these patients.
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Figures 11-32 and 11-4 are skin injuries in patients who underwent fluoroscopically guided invasive cardiologic procedures. The patient in Figure 11-3 underwent coronary angioplasty and stent placement involving 63 minutes of fluoroscopy and about 5000 frames of cine fluorography. The ...