Percutaneous Transluminal Angioplasty of Subclavian Artery Lesions

Abstract

Introduction: Percutaneous transluminal angioplasty (PTA) is one of the treatment options for stenotic and obstructive lesions of the subclavian artery. Aim: To evaluate initial and long-term results of percutaneous transluminal angioplasty of subclavian artery lesions. Methods: During period February 2016 to December 2017, 26 patients (12 men and 14 women) with significant subclavian artery stenosis and occlusion were admitted and underwent PTA. All patients were symptomatic. All PTA procedures were performed with the patient under local anesthesia, through the femoral artery (n=22), brachial artery (n=4), or combined route (n=6). In 7 patients, we performed direct stenting, while in the other 15 patients we performed predilatation before stent implantation. The follow-up protocol consisted of regular clinical examinations in 1, 3, 6 and 12 months post-procedural, and annually thereafter with duplex ultrasound monitoring. Results: Initial technical success was achieved in 22 of 26 procedures (84.61%), 100% in stenotic lesions and 55.5 % in total occlusions. Fourth of nine occlusions could not be recanalized by PTA. These patients were managed surgically. The 30-day mortality rate was 0% for the entire group. No patients required reintervention for recurrence of symptoms and the stents remain patent at period of 12 months post-procedural. Conclusion: The minimal invasive technique, the markedly lower complication rate, the high long-term patency, patient’s comfort and the decreased hospital stay have made endovascular repair the primary choice of treatment in the majority of cases, especially in patients with stenotic lesions and high-risk patients. We consider PTA of subclavian artery stenotic/obstructive lesions should be the first therapeutic option.

Virtual Reality-Assisted Percutaneous Transluminal Angioplasty for Interventional Treatment of Lower-Extremity Arteriosclerosis Obliterans

“…PTA uses an inflation balloon to expand at the vascular stenosis to relieve the vascular stenosis, which can reduce the damage caused by the stent coating to the diseased blood vessel [ 6 ]. It is mainly to treat complex lesions such as tortuous, diffuse, and severe stenosis, but the interaction between the balloon and the blood vessel can easily cause damage to the blood vessel wall [ 7 ].…”

Critical Left Subclavian Artery Stenosis With Retrograde Vertebral Flow: A Case Report and Literature Review

“…PTA is a minimally invasive procedure that has been shown to be effective in improving symptoms and restoring blood flow in patients with subclavian artery stenosis [ 3 , 11 ]. There remains some debate regarding the optimal treatment approach for subclavian artery stenosis, particularly in terms of the use of medical management versus interventional procedures [ 6 , 12 ]. However, a recent cohort study of 100 patients demonstrated that medical management when combined with either PTA or bypass surgery improved all-cause mortality by over three-fold and lowered adverse cardiovascular outcomes, compared to medical management alone [ 5 ].…”

Diagnostic and Treatment Algorithm in a Plurivascular Patient – Case Report

“…Subclavian artery stenosis has been shown to affect about 9% of patients with known PAD. 2 Also, half of patients with subclavian artery disease might have coronary artery disease, 3 and renal artery stenosis often is associated. 4 The symptoms caused by each stenotic segment are well known, but prioritizing the investigations and interventional treatment for each atherosclerotic involvement can be a challenge, especially if they are diagnosed in the same patient simultaneously.…”