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Dealing with symptomatic stenosis of the subclavian artery: Open or endovascular approach? A case report
Hozan Mufty1, Alfred Janssen2, Stijn Schepers1
1Department of Vascular Surgery, AZ Damiaan, Ostend, Belgium.
Introduction:
Stenosis of the subclavian artery is uncommon and it rarely causes symptoms. Only symptomatic patients should be treated.
Presentation Of Case:
We report a case of chronic left upper limb ischemia caused by subclavian artery stenosis after repetitive clavicular fixation. The stenosis was first treated with carotid-subclavian bypass and soon followed by angioplasty and stenting of the subclavian artery because of occlusion of the bypass. Finally, failure of these procedures necessitated a subclavian-axillary crossover bypass.
Discussion:
Both extra-anatomic bypass and percutaneous transluminal angioplasty are safe and effective. If feasible, many authors use endovascular treatment. According to literature, extra-anatomic bypass still remains the first choice of treatment for symptomatic patients. However, the introduction of routine stent implantation is equalling these results. Because of its lower long-term patency rate, endovascular treatment is favorable for patients at high risk.
Conclusion:
Our case is a good example of difficulties involved in choosing the best treatment option for subclavian artery stenosis.
