Arterial reconstruction for subclavian obstructive disease: a comparison of extrathoracic procedures
| Autor: | D.M. Scharn, J.A. van der Vliet, H.W. Palamba, F.G.M. Buskens, S.F.S. van Roye |
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| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Arterial reconstruction for aortoiliac occlusion disease Subclavian Artery Hemodynamics Arterial reconstruction Disease Postoperative Complications Symptom relief Ischemia medicine.artery medicine Retrospective analysis Methods Vertebrobasilar Insufficiency Humans cardiovascular diseases Vertebrobasilar insufficiency GeneralLiterature_REFERENCE(e.g. dictionaries encyclopedias glossaries) Subclavian artery Vascular Patency Retrospective Studies Medicine(all) Graft patency business.industry Middle Aged medicine.disease Arteriële reconstructie in het aortoiliacale traject Surgery body regions surgical procedures operative cardiovascular system Arm Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Vascular and Endovascular Surgery, 9, pp. 454-458 European Journal of Vascular and Endovascular Surgery, 9, 4, pp. 454-458 European Journal of Vascular and Endovascular Surgery, 9, 454-458 |
| ISSN: | 1078-5884 |
| Popis: | Objectives:Comparison of the immediate and long-term results of three different extrathoracic arterial reconstruction procedures for subclavian obstructive disease.Design:Retrospective analysis of 51 extrathoracic subclavian artery reconstructions in 49 patients performed in a single centre over an 18-year period (mean follow-up 64 months, range 3–192).Methods:Carotid-subclavian bypass (CSB, n = 21), subclavian-carotid transposition (SCT, n = 21) and subclavian-subclavian or axillo-axillary cross-over bypass (COB, n = 9) was performed. Upper extremity ischaemic complaints were present in 45/49 patients (92%) and vertebrobasilar insufficiency in 25/49 patients (51%). Symptom relief, improvement of haemodynamic parameters and graft patency were compared.Results:Operation time was significantly shorter (p < 0.001, t-test) in SCT (80 ± 5 min) compared to CSB (112 ± 7 min) and COB (116 ± 6 min). Symptom relief and improvement of haemodynamic parameters were similar for all groups. There were no differences in morbidity rate and there was no mortality. The cumulative patency of SCT was significantly better with 100% at 2, 5 and 10 years postoperatively compared to CSB (75.6%, 62.6% and 52.2%, respectively) (p < 0.005, log-rank test) and COB (76.5%, 63.7% and 63.7%, respectively) (p < 0.02, log-rank test). There was a tendency for a better patency in prosthetic grafts as compared to autologous vein grafts in CSB (ns, log-rank test).Conclusions:Satisfactory immediate and long-term results were obtained with all of the above techniques. When technically feasible, SCT is the procedure of choice for extrathoracic arterial reconstruction in subclavian obstructive disease. |
| Databáze: | OpenAIRE |
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