[Endovascular procedures in the treatment of obstructive lesions of the brachiocephalic arteries].
BACKGROUND
To assess the early effects, possible risks, and long term results of percutaneous transluminal angioplasty (PTA) of brachiocephalic trunk (BT) and subclavian arteries (SA).


METHODS
During the period of 11 years, in 92 patients (57 males--62%, mean age 53.5 +/- 7.8 years) 93 PTA of SA/BT were performed; 70 (75%) lesions were stenosis, while 23 (25%) lesions were occlusions with mean diameter stenosis percent of 83.1 +/- 6.2%. Clinical indications were: vertebrobasilar insufficiency (n = 57), upper limb ischemia (n = 40), coronary steal syndrome (n = 4) and scheduled aorto-coronary bypass, using internal thoracic artery (ITA) (n = 4 asymptomatic patients). Mean lesion length was 22 +/- 8 mm.


RESULTS
Eighty one (87%) out of 93 lesions were successfully dilated; all of 12 (13%) failures were due to unsuccessful recanalisation of occluded arteries. In 10 patients 10 stents were implanted (2 in BT and 8 in left SA). There were 6 (6.5%) procedural complications: 1 dissection, 1 thrombosis of the left SA, transient ischemic attack in 2 patients, and 2 cases of dislocation of atheromatous plaque from the right SA into the right common carotid artery. During the follow-up of 48 +/- 3 months, 16(20%) restenoses were treated by PTA (n = 7) or operatively (n = 9). Primary and secondary patency for all lesions treated during 11 years was 87% and 80%, respectively (stenosis: 97% and 89%; occlusions: 58% and 58%).


CONCLUSIONS
PTA with or without stenting was relatively simple, efficient and safe procedure. It required short hospitalization with low treatment costs. If any of suboptimal results or chronic occlusions were present, the implantation of endovascular stents should have been considered.
Institut za kardiovaskularne bolesti Dedinje, Beograd.
Dragan
D
Sagić
Dorde
D
Radak
Miodrag
M
Perić
Nenad
N
Ilijevski
Zoran
Z
Sajić
Branko B
BB
Petrović
Milutin
M
Mirić
D000800:Angioplasty, Balloon / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence