Document Detail


PTA of the subclavian and innominate arteries: long-term results.
MedLine Citation:
PMID:  10409923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To investigate the long-term clinical and duplex sonographic results of percutaneous transluminal angioplasty (PTA) of the subclavian and innominate arteries, and the potential of a new double balloon technique to avoid cerebrovascular thromboembolism.
PATIENTS AND METHODS: Forty-three PTAs were performed on 38 subclavian, four innominate arteries and one subclavian-subclavian bypass in 37 patients. In three instances a protective double balloon technique was used. Indication for the intervention was: subclavian steal syndrome (n = 14 [38%]), upper extremity arterial insufficiency (n = 26 [70%]), peripheral thromboembolism (n = 8 [22%]) and PRIND/stroke (n = 3 [8%]). Analysis of long-term follow-up (median 15, range 2 to 100 months) was possible of 28 patients including duplex sonographic assessment in 23 patients. The cumulative patency rate was calculated by means of life-table analysis.
RESULTS: Technical success was achieved in 36 endovascular procedures (84%). Minor peripheral catheter complications occurred in three interventions (7%), cerebrovascular thromboembolism in four (9%). No cerebrovascular complications were seen using the double balloon technique. On final check-up 4 patients (14%) suffered from subclavian steal syndrome, 3 (11%) from mild upper extremity arterial insufficiency and one (4%) from rest pain. Duplex sonography showed no stenosis in 12 of 23 patients (52%) and a stenosis of less than 50% in 8 (35%). The life-table analysis showed a secondary cumulative patency rate of 72% after 100 months with all restenoses occurring within 24 months.
CONCLUSIONS: PTA of the subclavian and innominate arteries appears to be a useful alternative to surgery with a low complication rate. The long-term patency rate of 72% is comparable to results of other series. In high risk situations cerebrovascular complications may be reduced using the new double balloon technique.
Authors:
M Körner; I Baumgartner; D D Do; F Mahler; G Schroth
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  VASA. Zeitschrift für Gefässkrankheiten     Volume:  28     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-09-08     Completed Date:  1999-09-08     Revised Date:  2012-10-19    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  117-22     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University Hospital Berne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography, Digital Subtraction
Angioplasty, Balloon*
Arterial Occlusive Diseases / diagnosis,  etiology,  therapy*
Blood Flow Velocity / physiology
Brachiocephalic Trunk*
Female
Follow-Up Studies
Humans
Life Tables
Male
Middle Aged
Subclavian Artery*
Ultrasonography, Doppler, Duplex

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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