Endovascular procedures in the treatment of obstructive lesions of brachiocephalic arteries

Sagić, Dragan; Radak, Djordje; Perić, Sanja; Ilijevski, Nenad; Sajic, Zoran; Petrović, B; Miric, P Milutin

doi:10.2298/vsp0203255s

Cited by 2 publications

(1 citation statement)

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“…In the PTA/stenting group, we mostly used transfemoral approach (92%), while transaxillary approach (8%) was used in cases of changes in aorto-iliac region and in cases of total arterial occlusion of proximal segment of subclavian artery. Apart from these two approaches used to treat most of their patients, Sagić et al 18,19 and Babic et al 20 described patients treated with "snare" technique using combined axillary and femoral approach. A bidirectional approach is mostly used for chronic total occlusions and much calcified lesions 21 .…”

Section: Discussionmentioning

confidence: 99%

Subclavian steal syndrome - surgical or endovascular treatment

Cvetić¹,

Colić²,

Radmili³

et al. 2017

VOJNOSANIT PREGL

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Background/Aim. A phenomenon of subclavian steal is caused by occlusion or stenosis of the proximal subclavian artery with subsequent retrograde filling of the subclavian artery via the ipsilateral vertebral artery. The aim of this research was to compare surgical method [carotid-subclavian bypass grafts (CSBG)] and endovascular methods [percutaneous transluminal angioplasty (PTA) and stenting of subclavian artery] from the aspect of immediate and long-term results. Methods. Thirty patients [16 (53.33%) males], of average age between 60.1 ± 8.25 years were treated with CSBG and compared with a group of forty patients [18 (45%) males], of the average age between 57.75 ± 6.15 years treated by PTA and stenting of subclavian artery. Immediate and long-term results were determined clinically and confirmed by Doppler pressures and duplex ultrasound/angiography. All patients were followed-up after 1, 6 and 12 months post-procedure, and annually thereafter. Results. The average follow-up for both groups was 22.37 ± 11.95 months. There were 2 (6.67%) procedural complications in the CSBG group (transient ischemic attack in 2 patients) and 3 (7.5%) ones in the PTA/stent group (dissection and distal embolization in one patient and puncture site hematoma in one patient). Systolic blood pressure difference between the two brachial arteries in CSBG group was: 42.6 ± 14.5 mmHg vs 4.75 ± 12.94 mmHg (p < 0.05). In the PTA/stent group it was: 41.2 ± 15.35 mmHg vs 3.58 ± 5.83 mmHg (p < 0.05). Long-term success was 93.33% in the CSBG group and 92.5% in the PTA/stent group (p > 0.05). Conclusions. Both, the CSBG and PTA/stenting of subclavian artery are safe, efficacious and durable procedures. They have similar immediate and long-term results. PTA and stenting are the methods of choice for high grade stenosis, near total occlusions and segment occlusions of subclavian artery. CSBG is indicated in case of diffuse occlusive lesions and when the PTA and stenting do not succeed or cause complications.

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Section: Discussionmentioning

confidence: 99%