Initial and Long-Term Results of Endovascular Therapy for Chronic Total Occlusion of the Subclavian Artery
Initial and Long-Term Results of Endovascular Therapy for Chronic Total Occlusion of the Subclavian Artery
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DOI：
10.1007/s00270-011-0144-8
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发表时间：
2012-04-01
影响因子：
2.9
通讯作者：
Vucurevic, Goran
中科院分区：
文献类型：
--
作者：
Babic, Srdjan;Sagic, Dragan;Vucurevic, Goran
目的探讨血管成形术和支架置入术治疗锁骨下动脉慢性全闭塞（CTO）的初步和远期疗效。材料与方法1999年1月至2010年2月，56例患者（男性25例，平均年龄58±8岁）行血管内治疗SA CTO。双工扫描和动脉造影证实所有病例均有闭塞。再通指征为锁骨下窃血综合征33例（58.1%），手臂跛行13例（23.2%），冠状动脉缺血7例（12.5%），既往有冠状动脉搭桥术史，包括左胸内动脉搭桥术。3例患者（5.4%）在预定的冠状动脉搭桥手术前接受治疗，包括左胸廓内动脉移植。再通成功后，对所有患者进行支架置入，并于术后1、3、6、12个月随访，此后每年随访一次。结果46例（82.1%）患者冠脉再通成功，并发症发生率为7.1%。在随访期间（平均40 +/- 26个月，范围2 - 125），1年和3年后的原发性通畅率分别为97.9%和82.7%。在随访结束时，76%的动脉没有再狭窄的迹象。单因素分析未能确定任何预测SA再通成功的长期通畅的变量。结论经皮腔内血管成形术联合支架置入术是一种安全有效的方法，风险低，远期疗效好。
Purpose To study the initial and long-term results of angioplasty and primary stenting for the treatment of chronic total occlusion (CTO) of the subclavian artery (SA).Materials and Methods From January 1999 to February 2010, 56 patients (25 men with a mean age of 58 +/- 8 years) underwent endovascular treatment for CTO of the SA. Duplex scans and arteriograms confirmed occlusion in all cases. Indications for recanalization were subclavian steal syndrome in 33 patients (58.1%), arm claudication in 13 patients (23.2%), and coronary ischemia in 7 patients (12.5%) who had a history of previous coronary artery bypass grafting that included left internal thoracic artery graft. Three patients (5.4%) were treated before the scheduled coronary artery bypass surgery, which included left internal thoracic artery graft. After successful recanalization, all arteries were stented, and all of the patients were followed-up at 1, 3, 6, and 12 months after surgery and annually thereafter.Results Successful recanalization of the SA was achieved in 46 patients (82.1%), and the complication rate was 7.1%. During follow-up (mean 40 +/- 26 months; range 2 to 125), the primary patency rates after 1 and 3 years were 97.9% and 82.7%, respectively. At the end of follow-up, 76% of the arteries showed no evidence of restenosis. Univariate analysis failed to identify any variable predictive of long-term patency of successfully recanalized SA.Conclusion Percutaneous transluminal angioplasty with stenting of the complete total occlusion of the SA is a safe and effective procedure associated with low risks and good long-term results.