Endovascular Stenting vs. Extrathoracic Surgical Bypass for Symptomatic Subclavian Steal Syndrome

Abstract

Both endovascular stenting and extrathoracic surgical bypass are safe and effective treatments for subclavian steal syndrome in the short and medium term; however, extrathoracic surgical bypasses are more durable in the long term.

Review of coronary subclavian steal syndrome

“…While several case reports and case series describe experiences using one particular technique, only six studies to date have compared the results of a percutaneous endovascular technique to surgical subclavian artery revascularization [50][51][52][53][54][55]. These six studies were published between 1989 and 2012, and as a result compare various open surgical techniques (carotidsubclavian bypass, carotid-to-carotid bypass, subclavian-to-subclavian bypass, subclavian-to-axillary bypass, and subclavian carotid transposition) to different endovascular techniques (PTA alone, PTA with balloon-expandable stent, PTA with self-expanding stent) as technology advanced and for different indications prohibiting a meaningful meta-analysis.…”

Subclavian Steal Syndrome

“…8,[14][15][16][17][18][19][20] Balloon angioplasty and stenting can be performed when stenting is unlikely to compromise the vertebral circulation. Technical success of the percutaneous approach can be achieved in >90%, with 5-year patency rates of 85%.…”

Open Reconstructions for Symptomatic Atherosclerotic Lesions of the Supra-aortic Vessels: Thirty Years Results from Two University Hospitals

“…21,22 Although there are studies concluding that endovascular approach is as safe and efficacious as the open surgical treatment, even for high-grade lesions, 23,24 Farina et al 25 showed a statistically increased restenosis rate after PTA compared with surgery. In addition, AbuRahma et al 26 compared the results of PTA/stenting in the subclavian artery with the results of CSBP grafts.…”