Outcome of Conservative versus Interventional Treatment of Subclavian Artery Stenosis

Schillinger, Martin; Haumer, Markus; Schillinger, Sabine; Mlekusch, Wolfgang; Ahmadi, Ramazanali; Minar, Erich

doi:10.1177/152660280200900201

Cited by 40 publications

(22 citation statements)

References 22 publications

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“…Shillinger et al, Staikov et al and de Vries et al in their studies showed that the subclavian obstructive lesions are mostly located in the proximal segment of the subclavian artery, proximal to the origin of the vertebral artery and predominantly on the left side [11,15,16]. Because the left subclavian artery has a more prominent angle at its origin, it is likely that turbulent flow patterns in the aortic arch and at the origin of the subclavian artery are responsible for extensive plaque formation at this particular location accelerating atherosclerosis [17,18].…”

Section: Discussionmentioning

confidence: 97%

A case of acquired right-sided subclavian steal syndrome successfully treated with stenting using brachial approach

Dragičević¹,

Škorić²,

Kolić³

et al. 2014

CRCM

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Subclavian steal syndrome (SSS) is defined as a group of symptoms that arise from reversed blood flow in the ipsilateral vertebral artery. It is the consequence of proximal occlusion or highgrade stenosis of the subclavian artery. The subclavian obstructive lesions are mostly located in the proximal segment of the subclavian artery and predominantly on the left side. In contrast, there are only a small number of patients that present with right-sided symptoms and even fewer with bilateral symptoms. Endovascular therapy of occlusions and high-grade stenosis of subclavian artery proximal to the origin of the vertebral artery becomes an established therapy in last two decades. We report a case of successful endovascular treatment of right-sided subclavian steal and high-grade (80%) right subclavian artery stenosis due to atherosclerotic occlusive disease with balloon-expandable stent using brachial approach.

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Section: Discussionmentioning

confidence: 97%

A case of acquired right-sided subclavian steal syndrome successfully treated with stenting using brachial approach

Dragičević¹,

Škorić²,

Kolić³

et al. 2014

CRCM

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“…The presented results differ only slightly from the results of endovascular methods of treating simple arterial constrictions, and in addition yield better longterm results (1,16). For instance, in the paper by Schillinger et al (17), covering 107 subjects with previous endovascular interventions on the subclavian artery, the patency rate after 1 year, 3 and 4 years remained, respectively, on the level of 91%, 83%, 79%. In our own study, the primary patency in the follow-up period after 1 year, 3 and 5 years was 68% for SCB and 100% for SCT.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Indications and own Results of Surgical Treatment of occlusions of the initial section of the Left subclavian artery

Pukacki¹,

Zieliński²,

Oszkinis³

et al. 2010

Polish Journal of Surgery

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Symptomatic occlusion of the initial section of the subclavian artery, resistant to intravascular treatment, is an indication for a surgery as it exacerbates the verterbrobasilar insufficiency and creates the risk of peripheral embolism. Reconstructive surgery fixes the reversed blood flow in the vertebral artery, alleviates neurological and limb ischemia symptoms. the aim of the study was to retrospectively evaluate the results of surgical treatment of the occlusion of the initial section of the subclavian artery using transposition or subclavian-carotid by-pass with a PTFE. material and methods. Retrospective analysis covered 55 patients operated on between June 1996 and August 2008 for occlusion of the left subclavian artery. 39 patients underwent a subclavian artery transposition (SCT) and the remaining 16 had a subclavian-carotid by-pass (SCB) using a PTFE. Indications for surgery included ischeamic symptoms in the upper limb and impaired vertebrobasilar circulation. Clinical symptoms occurred in the following order: vertebrobasilar insufficiency and upper limb ischemia (62%), upper limb ischemia symptoms (22%), vertebrobasilar insufficiency (16%). Results. There were no early deaths (by day 30). Ischemia was lifted in 100% of the patients operated using transposition and in 93% of those with a by-pass. In the perioperative period, one patient had a bypass thrombosis, and 2 patients had a transitional brain ischemia. These incidents affected patients who underwent subclavian-carotid by-pass. In the late postoperative period, 12 patients (21.81%) died due to cardiological complications and 7 patients (12.72%) for other causes, and none of them was related to the primary surgery. All patients with transposition have maintained the primary patency, with average follow-up period of 73 months . In the group with a by-pass, occlusion occurred in 3 patients in the first follow-up month. These incidents had no effect on survival rates. For the remaining 14/16 patients from the SCB group the average primary patency was 63.4 (8-104) months. conclusions. Subclavian-carotid transposition is a safe and effective method of upper limb revascularization. It is technically more difficult than the by-pass but ensures a better short-term and long-term result.

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“…In a retrospective study evaluating outcomes in 274 patients treated with either a conservative (n = 165) or invasive (n = 109) approach for subclavian artery atherosclerotic disease with a median follow-up of 42 months, patients treated with PTA had a 60% risk reduction for the development of a hemodynamically signifi cant stenosis (P < 0.01), defi ned as an upperextremity blood pressure diff erential of ≥20 mm Hg compared with conservative treatment (7).…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy of Axillary Artery Disease with Drug-Coated Balloon Angioplasty

Al’Aref

Swaminathan

Feldman

2017

Baylor University Medical Center Proceedings

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Outcome of Conservative versus Interventional Treatment of Subclavian Artery Stenosis

Cited by 40 publications

References 22 publications

A case of acquired right-sided subclavian steal syndrome successfully treated with stenting using brachial approach

A case of acquired right-sided subclavian steal syndrome successfully treated with stenting using brachial approach

Contemporary Indications and own Results of Surgical Treatment of occlusions of the initial section of the Left subclavian artery

Endovascular Therapy of Axillary Artery Disease with Drug-Coated Balloon Angioplasty

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