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Stenting for atherosclerotic occlusive disease of the subclavian artery

J A Rodriguez-Lopez1, A Werner, R Martinez

  • 1Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix 85006, USA.

Annals of Vascular Surgery
|May 29, 1999
PubMed

Insights

Subclavian artery stenting is a safe and effective treatment for stenosis and occlusion, improving symptoms like vertebrobasilar insufficiency and upper limb ischemia. While short- and mid-term results are promising, long-term durability requires further investigation.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Devices

Background:

  • Subclavian artery disease, including stenosis and occlusion, can lead to significant symptoms such as vertebrobasilar insufficiency and upper limb ischemia.
  • Traditional treatments like balloon angioplasty alone have shown limitations in efficacy and durability.
  • Stenting offers a potential solution to improve outcomes in these challenging vascular lesions.

Purpose of the Study:

  • To evaluate the safety and efficacy of subclavian artery stenting for treating atherosclerotic lesions.
  • To assess the outcomes of stenting in patients with various indications, including vertebrobasilar insufficiency and upper limb ischemia.
  • To compare the results of stenting with previous reports of balloon angioplasty alone.

Main Methods:

  • A retrospective study involving 69 patients (70 subclavian arteries) treated between July 1991 and December 1995.
  • Patients underwent intraluminal balloon dilatation followed by stent implantation for primary atherosclerotic stenoses (>70%) or total occlusions.
  • Indications included vertebrobasilar insufficiency, upper limb ischemia, subclavian steal phenomenon, and protection of vascular access or bypass grafts.

Main Results:

  • Stenting was performed for stenosis in 78% of cases and for total occlusion in 22%.
  • Successful treatment was observed for various indications, with significant improvements in symptoms.
  • Short- and mid-term patency rates were good, demonstrating the feasibility and safety of the procedure.

Conclusions:

  • Subclavian artery stenting is a safe and feasible option for treating atherosclerotic stenosis and occlusion.
  • The procedure offers improved short- and mid-term patency compared to balloon angioplasty alone.
  • Long-term durability of subclavian artery stenting remains to be determined through further follow-up studies.

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