Radiodermatitis lesions and medico-legal implications: a systematic review

Background.The Percutaneous Transluminal Coronary Angio- plasty (PTCA) is an interventional cardiology procedure that allows revascularisation of ischemic myocardial areas both in acute and chronic settings. Over the years, this technique has improved in terms of efficacy, changing the therapeutic approach of myocardial ischemic pathology, with a significant reduction in the mortality rate of myocar- dial infarction. However, it does not appear free from complications, one of which, although very rare, is radiodermatitis, that is frequently correlated to acute or/and low dose ionizing radiation exposure and oxidative stress. Material and Methods. In this regard, the Authors proceeded to a review of the literature concerning the harmful effects of radiation during fluoroscope-guided procedures, underlining in particular the difficulties of univocally determining a “threshold dose” beyond which to define the onset of radiodermitic phenomena. Results. It has been highlighted how the onset of radiodermitic manifestations following PTCA is of primary medical-legal interest, since it is possible to recognise the existence of responsibility profiles in the hands of the healthcare professionals, and therefore the occurrence of compensation claims by patients. Conclusion. No specific contribution emerged from the literature consulted, so authors put forward the essential elements for a correct classification of healthcare responsibility and the evaluation of any consequent damage to the person concerned.