Angioplasty of subclavian artery stenosis proximal to the vertebral origin

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Cardiovascular Disease

Background:

• Proximal left subclavian artery stenosis can cause significant symptoms and increase stroke risk.
• Surgical revascularization options have limitations and associated morbidity.
• Percutaneous transluminal angioplasty offers a less invasive alternative for treating these stenoses.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous transluminal angioplasty for symptomatic proximal left subclavian artery stenosis.
• To assess the technical success and clinical outcomes of this endovascular procedure.
• To identify potential complications associated with angioplasty in this patient cohort.

Main Methods:

• Nine patients with symptomatic proximal left subclavian artery stenoses underwent percutaneous transluminal angioplasty.
• The procedure involved balloon angioplasty to open the narrowed artery.
• Patients were followed for 4-23 months to assess outcomes and complications.

Main Results:

• All nine cases achieved technical success, indicating successful opening of the stenotic lesions.
• Eight out of nine patients remained asymptomatic during the follow-up period.
• One patient experienced a significant delayed complication: common carotid-to-subclavian artery bypass graft occlusion with probable embolic occlusion of the internal carotid artery.

Conclusions:

• Percutaneous transluminal angioplasty is a technically successful treatment for symptomatic proximal left subclavian artery stenosis.
• The procedure demonstrates a favorable short-to-medium term outcome with most patients remaining asymptomatic.
• Vigilance for delayed complications, such as graft occlusion and embolism, is warranted.