title: Results after balloon angioplasty or stenting of atherosclerotic subclavian artery obstruction.
abstract: BACKGROUND
  Endovascular therapy is an accepted treatment strategy in occlusive disease of the subclavian artery. The purpose of this study was to evaluate the technical and clinical long-term outcome following either balloon angioplasty (plain balloon angioplasty (PTA)) or stenting.
  
  
  METHODS
  The authors retrospectively analyzed 108 interventions of atherosclerotic lesions of subclavian arteries or the brachiocephalic trunk (107 patients; mean age of 66 +/- 9 years; 90% symptomatic) representing 92% of the patients treated with subclavian artery obstructive disease during a 10-year period. Primary endpoint of the study was the 1-year primary patency rate. Follow-up was based on oscillometry, Doppler blood pressure measurements, and duplex ultrasound.
  
  
  RESULTS
  The primary success rate was 97% (100% for stenoses (78/78) and 87% for total occlusions (26/30)). Treatment modalities included PTA alone (13%; n = 14) or stenting (87%; n = 90) with balloon-expandable (n = 61), self-expanding (n = 17), or both types of devices (n = 12). The 1-year primary patency rate of the 97 patients eligible for follow-up was 88%, for the subgroups 79% (PTA) and 89% (stenting; P = 0.2). The blood pressure difference between both limbs at baseline was 45 +/- 26 mm Hg and dropped to 10 +/- 14 mm Hg (P < 0.001) after the intervention and 15 +/- 19 mm Hg at 1 year (P < 0.01).
  
  
  CONCLUSIONS
  Endovascular therapy of atherosclerotic subclavian artery obstructions result in excellent acute success rates even in total occlusions. Results evince good durability of endovascular therapy for atherosclerotic occlusive disease of subclavian arteries and with a trend towards better outcome with stenting compared to PTA.
authors.affiliation: Department of Angiology, Heart Centre, Bad Krozingen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sixt
authors.forename: Aljoscha
authors.initials: A
authors.lastname: Rastan
authors.forename: Uwe
authors.initials: U
authors.lastname: Schwarzwälder
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Bürgelin
authors.forename: Elias
authors.initials: E
authors.lastname: Noory
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwarz
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beschorner
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frank
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Michael
authors.initials: M
authors.lastname: Hauk
authors.forename: Olli
authors.initials: O
authors.lastname: Leppanen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Hauswald
authors.forename: Regina
authors.initials: R
authors.lastname: Brantner
authors.forename: Taher
authors.initials: T
authors.lastname: Nazary
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Thomas
authors.initials: T
authors.lastname: Zeller
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome