Endovascular treatment of late coronary-subclavian steal syndrome

Abstract

A tailored endovascular approach can be used to treat CSSS. However, the occurrence of potentially lethal complications is possible and needs prompt correction.

Subclavian artery stenting for coronary‐subclavian steal syndrome

“…In our study, high success rates were obtained in stenosis (30/30, 100%) and occlusion lesions (6/7, 85.7%), whereas only a few minor complications, typically related to interventional procedures, were observed, similar to the findings of previous reports . Though our procedures were carried out in the absence of embolism protection devices, only one patient experienced transient ischemic attack without any strokes.…”

“…The time elapsed between bypass surgery and the diagnosis of CSSS differed from previous studies . In our study, the mean time was 6.3 years.…”

“…Severe stenosis (≥70%) often caused stable or unstable angina or even myocardial infarction, whereas unstable angina or myocardial infarction were more frequent among occluded lesions because severe SAS compromised or even reversed the flow of IMA. Previous studies have shown that the symptomatic remission rate after the release of brachiocephalic and subclavian arterial stenosis fluctuates between 90% and 100% . The actuarial remission rate of 94.6% for subclavian artery stenting in this study reflected the effectiveness of this practice.…”

“…This study is also the first to research endovascular therapy for the treatment of CSSS in Chinese patients. Our results provide some improvement upon the results of Takach et al and Faggioli et al , especially considering the angiography to assess follow‐up outcomes, which covered two‐thirds of the patients for more than 3 years. Our findings indicate that endovascular stenting of CSSS at experienced medical centers was safe and effective, with a low incidence of complication and in‐stent restenosis.…”

“…Overall, the incidence of CSSS was estimated to be 0.2–3.4% for patients with IMA‐CABG. Some case reports and small series have shown the feasibility of endovascular therapy of SAS for CSSS . However, due to small sample sizes and the short follow‐up durations of these studies, further exploration and evaluation were needed.…”