title: Long-term treatment outcomes after intravascular ultrasound evaluation and stent placement for atherosclerotic subclavian artery obstructive lesions.
abstract: The objective of this study was to determine long-term outcomes after stent placement for subclavian artery (SA) obstructive lesions assisted by intraoperative intravascular ultrasound (IVUS). The study included 25 lesions in 24 patients who underwent stent placement assisted by intraoperative IVUS for subclavian artery stenosis or obstruction at our hospital between January 2003 and August 2010. Outcome was evaluated based on the results within 30 postoperative days (technical success rate, improvement in upper extremity ischemia, steal syndrome, left-right blood pressure difference, and perioperative complications) and the results after 30 postoperative days (incidence of vertebrobasilar artery territory infarction and restenosis). Stent placement and vessel dilatation were successful in all patients, without perioperative complications. Upper extremity ischemia, steal syndrome, and left-right blood pressure difference disappeared in all cases. During follow-up observation (6-96 months; median 51 months), no restenosis occurred at the stent placement site in any patient. In one case, four years after initial treatment, stenosis was noted proximal to the stent placement site. Satisfactory long-term as well as short-term outcomes were achieved after stent placement for SA obstructive lesions assisted by intraoperative IVUS evaluation.
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan - twneuro@m5.kcn.ne.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.affiliation: Department of Radiology and Interventional Neuroradiology, Ishinkai Yao General Hospital; Yao, Osaka, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Takayama
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Taoka
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakagawa
authors.affiliation: Department of Radiology and Interventional Neuroradiology, Ishinkai Yao General Hospital; Yao, Osaka, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Myouchin
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan.
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Miyasaka
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Akashi
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Department of Radiology, Nara Medical University; Kashihara, Nara, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*
keywords: atherosclerotic subclavian artery obstructive lesions; intravascular ultrasound; stent placement
references.citation: J Vasc Surg. 1994 Sep;20(3):411-7; discussion 417-8
references.pmid: 8084034
references.citation: Catheter Cardiovasc Interv. 2008 Jun 1;71(7):963-8
references.pmid: 18383169
references.citation: Catheter Cardiovasc Interv. 2009 Feb 15;73(3):395-403
references.pmid: 19214979
references.citation: Cardiovasc Intervent Radiol. 2004 Nov-Dec;27(6):616-23
references.pmid: 15578138
references.citation: J Am Coll Cardiol. 2011 Feb 22;57(8):e16-94
references.pmid: 21288679
references.citation: Int Angiol. 2007 Dec;26(4):324-40
references.pmid: 18091700
references.citation: Ann Surg. 1994 Jun;219(6):673-7; discussion 677-8
references.pmid: 8203976
references.citation: Chin Med J (Engl). 2010 Jan 5;123(1):45-50
references.pmid: 20137574
references.citation: J Endovasc Surg. 1996 May;3(2):171-81
references.pmid: 8798136
references.citation: Cardiovasc Surg. 1993 Oct;1(5):530-5
references.pmid: 8076091
references.citation: J Vasc Surg. 1990 Dec;12(6):716-22; discussion 722-3
references.pmid: 2147042
references.citation: Catheter Cardiovasc Interv. 2004 Nov;63(3):364-70
references.pmid: 15505851
references.citation: J Vasc Surg. 2005 Jan;41(1):19-23
references.pmid: 15696038