[Atherosclerotic lesions of the subclavian artery. Indications for subclavian carotid transposition].
OBJECTIVE
To analyze the clinical and anatomical outcome after subclavian carotid transposition and to compare the results with other surgical procedures.


METHODS
The hospital records of 51 patients undergoing subclavian carotid transposition were reviewed retrospectively for preoperative symptoms, Doppler and arteriography findings, preoperative details and postoperative complications. Long-term patency and symptoms were determined by physical and Doppler examination during the follow-up.


RESULTS
The indications for subclavian transposition were: vertebrobasilar ischemia (24%), ischemia of the upper limb (45%), asymptomatic occlusion or non-specific symptoms (31%). Subclavian artery transposition was associated with vertebral revascularization (7 cases), and homolateral carotid surgery (11 cases). There were no deaths. Early occlusions occurred in two cases, one required reoperation. Minor complications were observed in 21% of the patients with no permanent morbidity. Overall patency after a mean 54 months follow-up was 96%.


CONCLUSIONS
Subclavian carotid transposition is a good method for the treatment of proximal subclavian occlusive disease. Long-term patency can be achieved. Carotido-subclavian bypass should be limited to cases with extensive occlusive lesions as patency rate is lower.
Laurian
C
C
Service de Chirurgie Vasculaire, Hôpital Saint-Joseph, Paris.
Cron
J
J
Gigou
F
F
Saliou
C
C
Brisset
D
D
Soury
P
P
Angel
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002339:Carotid Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery*
Lésions athéroscléreuses de l'artère sous-clavière. Place de la transposition sous-clavière carotide.