title: [Stenting for proximal subclavian and brachiocephalic artery occlusion--preliminary results].
abstract: The authors report the initial results, between January 1998 and February 2001, of stenting utilizing the brachial approach in seven patients for total occlusions at the following locations: two right subclavian, one brachiocephalic, and five left subclavian arteries. All lesions were associated with subclavian steal syndrome. Indications for the treatment included ischemic symptoms in the affected arm (seven patients), and vertebrobasilar insufficiency (five patients). A total of eight stents were implanted in six occluded arteries, resulting in a 75% procedural success rate. Procedural complications encountered were two subintimal dissections by a 0.035-inch guide wire during recanalization, and one stent dislodgement with migration. There was no stroke, presumably because of the previously reported preventive effect of delayed reversal of a stealing vertebral artery. Follow-up over a mean duration of 11 months revealed no sign or symptom of recurrence in cases with initial technical success. The results of the current study, with a literature survey, indicated that percutaneous transluminal angioplasty with primary stent deployment in an occluded prevertebral segment of the subclavian or the brachiocephalic artery should be considered as an available choice for treatment. Further points, such as some remaining technical and clinical problems, will require more experience and consideration.
authors.affiliation: Department of Neurosurgery, Mie University School of Medicine, 2-174 Edobashi, Tsu-shi, Mie 514-8507, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sakaida
authors.forename: N
authors.initials: N
authors.lastname: Sakai
authors.forename: I
authors.initials: I
authors.lastname: Nagata
authors.forename: H
authors.initials: H
authors.lastname: Sakai
authors.forename: K
authors.initials: K
authors.lastname: Iihara
authors.forename: T
authors.initials: T
authors.lastname: Higashi
authors.forename: S
authors.initials: S
authors.lastname: Kogure
authors.forename: J
authors.initials: J
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Ohta
authors.forename: T
authors.initials: T
authors.lastname: Nagamine
authors.forename: R
authors.initials: R
authors.lastname: Anei
authors.forename: A
authors.initials: A
authors.lastname: Soeda
authors.forename: A
authors.initials: A
authors.lastname: Taniguchi
authors.forename: A
authors.initials: A
authors.lastname: Shindo
authors.forename: H
authors.initials: H
authors.lastname: Kikuchi
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D016122:Brachiocephalic Trunk; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013348:Subclavian Artery; D013349:Subclavian Steal Syndrome / Q000150:complications