Endovascular Treatment of the Subclavian Artery Steno-Occlusive Disease
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- 作者：Andrey Karpenko ; PhD ; Vladimir Starodubtsev ; PhD ; starodub@mail.ru ; Pavel Ignatenko ; MD ; Alexander Gostev
- 关键词：Subclavian artery occlusion ; vertebrobasilar insufficiency ; subclavian steal syndrome ; arm claudication ; recanalization of subclavian artery
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：26
- 期：1
- 页码：87-93
- 全文大小：549 K
- 卷排序：26
文摘
The aim of our study was to compare immediate and long-term results of endovascular interventions for the treatment of steno-occlusive disease of subclavian arteries (SAs) depending on the length of lesion.Materials and methodsBetween 2010 and 2013, we performed 245 endovascular procedures to treat patients with atherosclerotic steno-occlusive disease of SAs. All patients were examined and subdivided according to the received results into 2 groups: 125 patients with stenosis of SA were included in the first group and 120 patients with occlusion of SA were included in the second group. The patients were then followed up at 6, 12, 24, 36, and 48 months after endovascular interventions. Follow-up visits contained symptomatic evaluation, clinical assessment with physical examination, complete neurological evaluation, and serial color Doppler ultrasonography.ResultTransitory ischemic attacks in the vertebrobasilar system were intraoperatively developed by 1 patient from the first group (.8%) and 3 patients from the second group (2.5%). Reinterventions in the long-term period were carried out in 9 (7.2%) cases in the first group and 12 (10%) cases in the second group (P = .43). The cumulative primary stent patency at 4 years was 89.8% in the first group and 87% in the second group (P = .4).ConclusionsIn the case of SA occlusion on the first stage, it is expedient to carry out endovascular recanalization followed by stenting. Our study revealed an increased risk of stent thrombosis or in-stent restenosis in patients with stents >40 mm.