Subclavian Artery Calcification: A Narrative Review.

Area of Science:

• Vascular Surgery
• Cardiology
• Radiology

Background:

• Subclavian artery calcification (SAC) affects 2% of the population.
• SAC is a significant risk factor for developing subclavian steal syndrome (SSS).
• Risk factors include diabetes, hypertension, and smoking, with potential symptoms ranging from asymptomatic to ischemic gangrene.

Purpose of the Study:

• To review the risk factors, diagnostic methods, and treatment options for subclavian artery calcification and subclavian steal syndrome.
• To compare the efficacy and safety of endovascular versus surgical interventions.

Main Methods:

• Review of diagnostic modalities including duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA).
• Discussion of digital subtraction angiography (DSA) as the gold standard for stenosis grading.
• Analysis of endovascular options like percutaneous transluminal angioplasty (PTA) and stenting, alongside surgical interventions.

Main Results:

• While SAC is often asymptomatic, severe SSS can lead to neurological symptoms due to vertebrobasilar insufficiency.
• Imaging techniques like DUS, CTA, and MRA aid in diagnosis, with DSA being the gold standard.
• Endovascular management shows benefits in faster recovery, lower recurrence, and fewer complications compared to surgery.

Conclusions:

• Endovascular treatment is the preferred option for low-risk patients with SAC and SSS.
• Surgical intervention remains a gold-standard treatment option for complex cases.
• Early diagnosis and appropriate management are crucial for preventing severe complications of SSS.