Angiographic prevalence and clinical predictors of left subclavian stenosis in patients undergoing diagnostic cardiac catheterization.
The angiographic prevalence, clinical predictors, and sensitivity and specificity of a bilateral arm blood pressure differential for predicting proximal left subclavian artery stenosis were established in 492 patients undergoing cardiac catheterization. Seventeen subjects (3.5%) in the overall population and nine subjects (5.3%) with potential surgical coronary disease had proximal left subclavian stenosis. Precatheterization evidence of peripheral vascular disease (PVD) was the only predictor of subclavian stenosis in the overall population (P < 0.001; OR = 7.9; 95% CI = 2.6-24.3) and in patients with potential surgical coronary disease (P = 0.04; OR = 5.4; 95% CI = 1.1-27.2). Both a bilateral blood pressure differential of > 10 mm Hg and of > or =20 mm Hg had a good specificity but a poor sensitivity for predicting left subclavian stenosis. Thus, left subclavian angiography should be performed in patients with surgical coronary disease with either an arm blood pressure differential of > 10 mm Hg or with other precatheterization evidence of PVD. Cathet Cardiovasc Intervent 2001;54:8-11.
English
J A
JA
Department of Cardiology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, USA.
Carell
E S
ES
Guidera
S A
SA
Tripp
H F
HF
D000368:Aged; D001132:Arm / Q000503:physiopathology; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D006328:Cardiac Catheterization; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013348:Subclavian Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*