Stenting for atherosclerotic occlusive disease of the subclavian artery

Abstract

The purpose of this study was to evaluate the results of stenting subclavian artery pathologic lesions. Between July 1991 and December 1995, 69 patients (36 males: mean age 67 years, range 34-87 years) underwent intraluminal balloon dilatations followed by stent implantations in 70 subclavian arteries to treat primary atherosclerotic stenoses > 70%. Twenty-three patients (34%) were treated for vertebrobasilar insufficiency (VBI), 25 patients (36%) were treated for upper limb ischemia (ULI), and 10 patients (15%) were treated for both VBI and ULI. Other indications included symptomatic subclavian steal phenomenon (SSS), protection of dialysis arteriovenous fistula, coronary steal syndrome, protection of axilloaxillary bypass, distal embolization, and protection of left internal mammary artery (LIMA)-coronary bypass. Fifty-three cases (78%) were treated for stenosis and 17 cases (22%) for total occlusion of the origin of the subclavian artery. The results of this series indicate that stenting of subclavian artery stenosis appears safe and feasible with good short and mid-term patency, improving at those intervals the initial disappointing reports of balloon angioplasty alone. However, its long-term durability is at present unknown.