Results after balloon angioplasty or stenting of atherosclerotic subclavian artery obstruction
| Autor: | Thomas Schwarz, Thomas Zeller, Michael Hauk, Ulrich Beschorner, Christian Müller, Franz-Josef Neumann, Kirsten Hauswald, Ulrich Frank, Uwe Schwarzwälder, Sebastian Sixt, Karlheinz Bürgelin, Elias Noory, Aljoscha Rastan, Olli Leppänen, Taher Nazary, Regina Brantner |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Endpoint Determination medicine.medical_treatment Subclavian Artery Arterial Occlusive Diseases Balloon Subclavian Steal Syndrome Recurrence medicine.artery Angioplasty Internal medicine Clinical endpoint medicine Humans Radiology Nuclear Medicine and imaging Registries Subclavian artery Aged Retrospective Studies business.industry Ultrasound Stent Retrospective cohort study General Medicine Atherosclerosis Survival Analysis Surgery Radiography Treatment Outcome surgical procedures operative Blood pressure Cardiology Female Stents Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | Catheterization and Cardiovascular Interventions. 73:395-403 |
| ISSN: | 1522-726X 1522-1946 |
| DOI: | 10.1002/ccd.21836 |
| Popis: | INTRODUCTION: 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. PATIENTS AND 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). CONCLUSION: 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. |
| Databáze: | OpenAIRE |
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