Percutaneous transluminal angioplasty of subclavian arteries

The clinical records and procedural details of 30 subclavian angioplasty procedures attempted in 27 patients were reviewed. Long-term follow-up was obtained through referring physician records and direct telephone contact with the patients. Eight patients presented with neurologic symptoms only, six had arm claudication only, nine had both neurologic and arm symptoms, three underwent dilations to provide graft inflow, and one was asymptomatic. Procedural complications included a stroke in the contralateral carotid distribution, occurring during follow-up arch aortography, and an embolus in the fifth digit of the left hand, which was of no clinical significance. Long-term success did not correlate well with degree of stenosis, lesion length, or postangioplasty appearance. The patients with arm and neurologic symptoms who were followed up for 3 years experienced immediate relief and remained symptom free or improved, except for the patient who suffered the stroke and one patient with labyrinthitis.