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Updated: Jul 6, 2026
Brachial Artery Catheterization in Swine
Published on: March 30, 2019
Catheter-based treatment of the subclavian and innominate arteries
Samir N Patel1, Christopher J White, Tyrone J Collins
1Department of Cardiology, Ochsner Clinic Foundation, New Orleans, Louisiana 70123, USA. spatel@ochsner.org
Insights
Catheter-based stenting effectively treats symptomatic subclavian and innominate artery (S/IA) atherosclerosis, offering excellent long-term patency and symptom relief. This minimally invasive approach is a safe and preferred revascularization method for suitable patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Atherosclerosis Treatment
Background:
- Symptomatic subclavian and innominate artery (S/IA) obstructive lesions traditionally managed with open surgery.
- Catheter-based endovascular therapies offer reduced morbidity and mortality compared to open surgery in various vascular beds.
Purpose of the Study:
- To evaluate the outcomes of catheter-based intervention for symptomatic S/IA atherosclerosis.
- To assess the safety and efficacy of stent placement in S/IA arteries.
Main Methods:
- Retrospective analysis of 170 patients undergoing primary stent placement in 177 S/IA arteries between December 1993 and May 2006.
- Indications included arm ischemia, subclavian steal syndrome, coronary-subclavian steal syndrome, and preparation for coronary bypass surgery.
Main Results:
- Technical success rate of 98.3% for stent placement.
- No procedure-related deaths; low stroke rate (0.6%).
- At 35.2 months follow-up, 82% of patients remained asymptomatic with 83% primary patency and 96% secondary patency.
Conclusions:
- Catheter-based stenting is a safe and effective treatment for symptomatic S/IA lesions.
- Achieves excellent patency rates and sustained symptom resolution in over 80% of patients.
- Percutaneous primary stent therapy is the preferred revascularization method for suitable S/IA anatomy.
Objectives:
We report outcomes in patients undergoing catheter-based intervention for symptomatic subclavian and innominate artery (S/IA) atherosclerosis.
Background:
Symptomatic S/IA obstructive lesions have traditionally been treated with open surgical revascularization. Catheter-based endovascular therapies reduce the morbidity and mortality associated with surgery in many vascular beds.
Methods:
Between December 1993 and May 2006, 170 patients underwent primary stent placement in 177 S/IA arteries. Indications for revascularization included arm ischemia (57%), subclavian steal syndrome (37%), coronary-subclavian steal syndrome (21%), and planned coronary bypass surgery with the involved internal mammary artery (8%).
Results:
Technical success was achieved in 98.3% (174/177) arteries, including 99.4% for stenotic lesions (155/156) and 90.5% for occlusions (19/21). There were no procedure-related deaths and one stroke (0.6%, 1/170). Follow-up was obtained in 151 (89%) patients at 35.2 +/- 30.8 months, with a target vessel revascularization rate of 14.6% (23/157). At last follow-up, 82% (124/151) of all treated patients remained asymptomatic with a primary patency of 83% and a secondary patency of 96%.
Conclusions:
Catheter-based revascularization with stents for symptomatic S/IA lesions is safe and effective with excellent patency rates and sustained symptom resolution in the majority (>80%) of patients over 3 years of follow-up. Percutaneous primary stent therapy is the preferred method of revascularization in patients with suitable anatomy.
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