Endovascular therapy for steno-occlusive subclavian and innominate artery disease.
BACKGROUND
This study investigated the safety and outcome of endovascular therapy for steno-occlusive subclavian or innominate artery disease at a single center over a long period of more than 2 decades. METHODS AND RESULTS: We retrospectively analyzed all endovascular procedures of stenosis or occlusion of the subclavian or innominate artery between January 1990 and October 2013. During the observation period, a total of 130 procedures were attempted in 127 mostly symptomatic patients with stenosis (n=108; 83%) or occlusion (n=22; 17%) of the subclavian (n=119; 92%) and innominate (n=11; 8%) artery. The overall technical success rate was 97.7% (n=127/130). Accounting for the type of lesion, the success rate for stenosis was 100% (n=108/108) and for total occlusion, 86% (n=19/22). The periprocedural complication rate was low and included stroke, transient ischemic attack, and access site complications of 0.8%, 1.5%, and 3.8%, respectively. During a mean follow-up of 28 months the rate of restenosis (>70%) was 12%. Due to the overall low event rate no significant lesion or procedural risk factor for the development of restenosis could be identified.


CONCLUSIONS
Stenosis and occlusion of the subclavian and innominate artery can be treated safely and successfully by endovascular therapy with excellent long-term patency.
Department of Cardiology, Klinikum Rechts der Isar, Technische Universität München.
Christian
C
Bradaric
Kristin
K
Kuhs
Philip
P
Groha
Michael
M
Dommasch
Nicolas
N
Langwieser
Bernhard
B
Haller
Ilka
I
Ott
Massimiliano
M
Fusaro
Wolfram
W
Theiss
Nicolas
N
von Beckerath
Adnan
A
Kastrati
Karl-Ludwig
KL
Laugwitz
Tareq
T
Ibrahim
D000368:Aged; D016122:Brachiocephalic Trunk / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery*; D013349:Subclavian Steal Syndrome / Q000601:surgery*