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Published on: July 9, 2020
[Percutaneous transluminal angioplasty of the subclavian arteries]
Y Korogi1, T Hirai, Y Sakamoto
1Department of Radiology, Kumamato University School of Medicine.
Insights
Percutaneous transluminal angioplasty (PTA) effectively treated subclavian artery stenosis in 11 patients, with a 92% success rate and no complications. Long-term follow-up showed no recurrence, suggesting PTA is a valuable treatment option.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Context:
- Subclavian artery stenosis can lead to serious symptoms, including vertebrobasilar insufficiency and upper limb ischemia.
- A significant pressure gradient across the stenosis was observed in most patients prior to intervention.
Purpose:
- To evaluate the complications and long-term outcomes of percutaneous transluminal angioplasty (PTA) for treating subclavian artery stenosis.
Summary:
- PTA was performed on 12 subclavian arteries in 11 patients, achieving a 92% success rate.
- Post-procedure, ipsilateral arm blood pressure significantly improved.
- No procedural complications were reported, and no restenosis occurred during a mean follow-up of 25.7 months.
Impact:
- Percutaneous transluminal angioplasty demonstrates a high success rate and favorable long-term results for subclavian artery stenosis.
- While PTA effectively addresses the stenosis, improvement in vertebrobasilar insufficiency symptoms may vary.
- This study supports PTA as a safe and effective treatment for subclavian artery stenosis.
Abstract:
We studied the complications and long-term results of percutaneous transluminal angioplasty (PTA) of subclavian artery stenosis in 11 patients. In all patients but one, the systolic blood pressure before PTA in the arm on the involved side was at least 30 mmHg lower than that in the opposite arm. PTA of 11 left subclavian arteries and one right subclavian artery was attempted. Five of the patients suffered from symptoms of vertebrobasilar insufficiency as well as ischemia of the upper limb, two had only cerebral symptoms, two had only ischemia of the upper limb, and another had no symptoms related subclavian arterial lesion. Standard techniques for PTA were employed, using the femoral route eight times and the axillary route four times. Angioplasty was successful in 11 lesions (92%). In the successfully treated patients, the blood pressure in the ipsilateral arm was significantly increased after PTA. No complications occurred during or after the procedure. The patients were followed for 2-74 months (mean 25.7 months). During this time, no recurrence of the stenosis was observed, although the symptoms of vertebrobasilar insufficiency did not always improve. These results suggest that PTA is useful for treating subclavian artery stenosis.
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