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Long-term results of primary stenting for subclavian artery disease
Akihiro Higashimori1, Nobuyuki Morioka, Shinnji Shiotani
1Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada City, Osaka, Japan.
Insights
Endovascular therapy (EVT) for symptomatic subclavian artery (SCA) disease offers effective initial success and long-term patency. This minimally invasive approach is suitable as a primary treatment option for proximal SCA obstructive disease.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Subclavian artery (SCA) disease management traditionally involves open surgery.
- Endovascular therapy (EVT) shows comparable initial success rates to open surgery.
- Long-term patency of EVT for SCA disease requires further evaluation.
Purpose of the Study:
- To assess the immediate and long-term outcomes of EVT for symptomatic SCA disease.
- To determine the efficacy and durability of EVT in treating SCA lesions.
Main Methods:
- Retrospective analysis of 59 consecutive patients (60 lesions) undergoing EVT for symptomatic SCA disease.
- Patient demographics, clinical presentations, procedural details, and follow-up data were collected.
- Mean patient age was 68 ± 10 years; common symptoms included vertebrobasilar insufficiency and arm claudication.
Main Results:
- Technical success rate of 93.3% was achieved, with 57 stents implanted.
- No procedure-related deaths occurred; stroke and embolic events were low (3.4% and 1.7%, respectively).
- Primary patency rates were high: 94.9% at 1 year, 90.8% at 3 years, and 85.8% at 5 years.
Conclusions:
- EVT is an effective treatment for symptomatic SCA disease, demonstrating good initial success and sustained long-term patency.
- The minimally invasive nature and positive outcomes support EVT as a first-line treatment for proximal SCA obstructive disease.
Objectives:
To evaluate initial and long-term results of endovascular therapy (EVT) for symptomatic subclavian artery (SCA) disease.
Background:
EVT for SCA disease has a similar success rate as open surgery, but the long-term patency of EVT alone is uncertain.
Methods:
We retrospectively studied 59 consecutive patients (42 males and 17 females) with 60 lesions. Mean patient age was 68 ± 10 years. Clinical symptoms were vertebrobasilar insufficiency in 21 patients (35.0%), arm claudication in 20 patients (33.3%), angina pectoris in 12 patients (20%), severe arm ischemia in 3 patients (5.0%), vascular access insufficiency in 3 patients (5.0%), and leg ischemia in 1 patient (1.7%). A total of 57 stents were implanted. All patients were followed up at 1, 3, 6, and 12 months after the procedure and annually thereafter.
Results:
The technical success rate was 93.3%. All patients for whom technical success was obtained received stents. There were four technical failures, all of which were owing to the failure of crossing the wire in occluded lesions. There were no procedure-related deaths. There were two stroke events (3.4%) and one embolic event (1.7%). Primary patency rates were 94.9, 90.8, and 85.8% at 1, 3, and 5 years, respectively.
Conclusions:
EVT for SCA disease is an effective treatment with regard to initial success rate, clinical efficacy, and long-term primary patency. This minimally invasive procedure is appropriate as the treatment of first choice for proximal subclavian arterial obstructive disease.