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CURRENT ISSUEGAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

A Journal on Internal Medicine and Pharmacology

Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index

Frequency: Monthly

ISSN 0393-3660

Online ISSN 1827-1812

 

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 January-February;172(1-2):1-9

    ORIGINAL ARTICLES

Results of endovascular therapy of the subclavian and innominate arteries in 63 patients

Åkesson M., Gottsäter A., Alhadad A.

Department of Vascular Disease, Skåne University Hospital, Malmö, Sweden

Aim: The aim of the study was to describe results from a single vascular unit of endovascular revascularisation of subclavian and innominate arterial disease.
Methods: Between April 1994 and March 2010, 63 patients (mean age 61.8±10.8 years, 41[65%] women) were endovascularly treated for subclavian and innominate arterial disease. Fourteen (22%) had upper extremity claudication, 5 (8%) acute arm ischemia, 6 (10 %) subclavian steal syndrome, 18 (29 %) both these symptoms, and one had a subclavian aneurysm. Three (5 %) had Takayasu’s arteritis. Percutaneous transluminal angioplasty (PTA) with stent placement was performed in 55 (87%) patients, and only PTA in the remaining 8 (13%). Follow-up was clinical and with duplex ultrasound, computed tomography angiography (CTA) or magnetic resonance imaging (MRI) after 3, 6, and 12 months depending on recurrence of clinical symptoms.
Results: Technical success was achieved in 63 (100%) patients. Systolic blood pressure difference between the brachial arteries was 74±57 mmHg before and 7±12 mmHg after intervention (P<0.02). Eleven of the 63 patients were lost to follow-up after initial management. The mean follow-up of the remaining 52 (83%) was 513±730 days, median 369 (IQR 70-569) days. Survival rate was 92 % at 12 months. Primary patency was 88% at 11±10 months and secondary patency 96%. One patient had restenosis after 13 months and two patients with Takayasu´s arteritis had restenosis after 1.5 and 6 months, respectively. Fatal procedure related complications occurred in two patients.
Conclusion: Endovascular therapy is a relatively safe and effective treatment for atherosclerotic disease in the subclavian and innominate arteries.

language: English


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