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