Screening for subclavian artery stenosis in patients who are candidates for coronary bypass surgery.
We prospectively evaluated 59 patients who were deemed candidates for coronary bypass surgery after coronary artery angiography for subclavian artery narrowing, which could compromise the ipsilateral internal thoracic artery graft. Bilateral arm blood pressure (BP) measurements, auscultation for supraclavicular or cervical bruits, and questioning about cerebrovascular ischemic symptoms were compared to brachiocephalic-subclavian arteriography. One neurologic complication occurred during arteriography. An upper extremity BP difference of > or = 15 mm Hg identified all patients with > or = 50% subclavian artery narrowing. We recommend brachiocephalic-subclavian arteriography only in patients with abnormal noninvasive screening for subclavian stenosis, not routinely.
Osborn
Larry A
LA
Department of Internal Medicine, Division of Cardiology, University Hospital, Veterans Affairs Hospital, Albuquerque, New Mexico, USA. losborn@salud.unm.edu
Vernon
Sarah M
SM
Reynolds
Bryan
B
Timm
T Craig
TC
Allen
Kathleen
K
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D001794:Blood Pressure; D003251:Constriction, Pathologic; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011859:Radiography; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000473:pathology*