Advanced Patient Selection for Percutaneous Transluminal Angioplasty and Stenting for Severe Symptomatic Stenosis of the Subclavian Artery: Quantitative Evaluation with DHI and SF-36 Questionnaires

Abstract

Objective: This study was designed to quantitatively evaluate the clinical effectiveness of percutaneous transluminal angioplasty and stenting (PTAS) in patients with severe symptomatic stenosis of the subclavian artery (SSS/SA) via the Dizziness Handicap Inventory (DHI) and SF-36 questionnaires.

Methods: This was a reanalysis of a prospective, single-center study which was conducted from 2015 to 2024. The inclusion criteria were 1) patients who had significant stenosis (≧70%) of a single SA, 2) medically refractory symptoms, 3) abnormal blood flow patterns in the ipsilateral vertebral artery on dynamic sonographic images, and 4) no other possible causes of dizziness. The questionnaires, including the DHI and SF-36, were administered one month before and approximately 6 months after the PTAS. The responder was defined as any improvement in DHI.

Results: Thirty-two patients were enrolled. The DHI score was 23.2 ± 14.4 before PTAS and 8.4 ± 9.4 at 6 months after PTAS for SSS/SA (P value<0.001). The scores for the vitality and mental health domains of the SF-36 were 53.4 ± 14.1 and 51.5 ± 11.0 before PTAS and 60.0 ± 11.3 and 55.6 ± 10.4 (P values = 0.009 and 0.036), respectively, at 6 months after PTAS. The 26 responders had significantly higher DHI scores and higher scores for the RP and bodily pain subscales on the SF-36 than the 6 nonresponders did.

Conclusions: PTAS can effectively treat SSS/SA and therefore relieve dizziness and improve quality of life in affected patients. The degree of improvement was especially significant in patients who had SSS/SA, experienced dizziness, and had a better quality of life; thus, patients with SSS/SA who are most likely to benefit from PTAS should be selected.

Keywords: Angioplasty and stenting; DHI; Dizziness; SF-36; Subclavian artery stenosis.