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Use of subclavian steal in treating chronic total subclavian artery occlusion
Pravin K Goel1, Nagaraja Moorthy
1Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Insights
Endovascular stenting successfully treated chronic total occlusion of the proximal left subclavian artery. The subclavian steal phenomenon served as a novel roadmap for crossing the challenging blockage.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Endovascular treatment is standard for subclavian artery stenosis.
- Proximal subclavian artery total occlusion presents significant endovascular challenges, including distal vessel nonvisualization and access site difficulties.
Observation:
- A 65-year-old male patient presented with chronic total occlusion of the ostial left subclavian artery.
Findings:
- Successful endovascular stenting was performed.
- The subclavian steal phenomenon was ingeniously utilized as a roadmap to successfully cross the occlusion.
Implications:
- This case demonstrates a viable endovascular strategy for complex proximal subclavian artery total occlusions.
- Utilizing the subclavian steal phenomenon can overcome challenges in crossing occlusions and facilitate successful stenting.
Abstract:
Endovascular treatment is a well-established option for subclavian artery stenosis. However, total occlusion of the proximal subclavian artery remains a challenge, posing difficulties of nonvisualization of distal vessels, access site issues, and deployment of vertebral embolism protection devices. A 65-year-old man with chronic total occlusion of the ostial left subclavian artery, underwent successful endovascular stenting in which the subclavian steal phenomenon was utilized as a roadmap to cross the occlusion.
