Percutaneous endovascular treatment of innominate artery lesions: a single-centre experience on 77 lesions.
OBJECTIVE
To assess primary success and safety of percutaneous transluminal angioplasty and/or stenting of innominate artery lesions and to compare its 30-day stroke/mortality level with the literature data.


METHODS
A total of 72 patients (77 stenoses, five recurrent, 58 symptomatic and 39 female) with seven innominate vessel occlusions, nine subocclusive lesions and 61 significant (>60%) stenoses of innominate artery treated between 2000 and 2009 were retrospectively reviewed. With the exception of seven, all procedures were performed using a transfemoral approach. A stent was implanted in 49 (63.6%) cases. Follow-up included neurological examination, carotid duplex scan and office/telephone interview.


RESULTS
Primary technical success was 93.5% (72/77). There was neither periprocedural (<48 h) death, nor major neurological complication. Minor periprocedural neurological complications consisted of 2/72 (2.6%) ipsilateral TIAs. Access site complications included 4 (5.2%) access site bleedings. Follow-up was achieved in 65/72 (90.3%) of all patients and 68 (88.3%) of all procedures for a mean of 42.3 months and revealed neither major neurological complication, nor additional TIA. The cumulative primary patency rate was 100% at 12 months, 98+/-1.6% at 24 months, and 69.9+/-8.5% at 96 months. The cumulative secondary patency rate was 100% at 12 and at 24 months, and 81.5+/-7.7% at 96 months. Log-rank test showed no significant difference (p=0.79) in primary cumulative patencies between PTA alone (n=28) or PTA/stent (n=49).


CONCLUSIONS
Transfemoral PTA with or without stent appears to be a safe treatment option for innominate artery lesions.
Paukovits
T M
TM
Heart Center, Faculty of Medicine, Semmelweis University, 1122 Gaal Jozsef Street 9, Budapest, Hungary. tomirko@t-online.hu
Lukács
L
L
Bérczi
V
V
Hirschberg
K
K
Nemes
B
B
Hüttl
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000503:physiopathology; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D006814:Hungary; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency