Che Wuqiang, Dong Hui, Jiang Xiongjing, Peng Meng, Zou Yubao, Song Lei, Zhang Huimin, Yang Yuejin, Gao Runlin
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Catheter Cardiovasc Interv. 2017 Mar;89(S1):601-608. doi: 10.1002/ccd.26902. Epub 2017 Feb 3.
To evaluate the safety and feasibility of subclavian artery stenting for coronary-subclavian steal syndrome (CSSS).
CSSS is a rare cause of myocardial ischemia due to ipsilateral subclavian artery stenosis in patients who have undergone coronary artery bypass graft. However, current knowledge of the optimal therapy for CSSS is limited.
The clinical data of 37 patients (33 male; mean age 65 ± 6 years) with CSSS who had undergone subclavian artery stenting between April 2007 and December 2015 were analyzed.
The time elapsed between bypass surgery and the diagnosis of CSSS was 6.3 ± 4.3 years (median 5.2 years, range 1.3 months to 17.8 years). The technical success rate was 97.3% (100% for stenosis, 85.7% for occluded lesions). One patient experienced a transient ischemic attack; a second patient developed flow-limiting dissection involving the ostium of the internal mammary artery; and a third patient had a puncture site hematoma. The mean stenosis of target lesions decreased from 87.6 ± 10.6% to 5.9 ± 5.0% immediately after the procedure. A total of 35 (94.6%) patients were discharged with a complete remission of myocardial ischemia. During a follow-up of 44 ± 32 (range 6-112) months, no patient suffered from stroke or myocardial infarction. Stent-restenosis related unstable angina developing in one patient at 36 months and in another patient at 11 months, both of whom were relieved after balloon angioplasty and remained asymptomatic until the last follow-up.
Subclavian artery stenting is feasible and safe in patients with CSSS, with a low incidence of perioperative complications and stent restenosis rate. © 2017 Wiley Periodicals, Inc.
评估锁骨下动脉支架置入术治疗冠状动脉-锁骨下动脉窃血综合征（CSSS）的安全性和可行性。
CSSS是冠状动脉旁路移植术后患者因同侧锁骨下动脉狭窄导致心肌缺血的罕见原因。然而，目前关于CSSS最佳治疗方法的认识有限。
分析2007年4月至2015年12月期间37例（33例男性；平均年龄65±6岁）接受锁骨下动脉支架置入术的CSSS患者的临床资料。
旁路手术与CSSS诊断之间的时间间隔为6.3±4.3年（中位数5.2年，范围1.3个月至17.8年）。技术成功率为97.3%（狭窄病变为100%，闭塞病变为85.7%）。1例患者发生短暂性脑缺血发作；第2例患者出现累及内乳动脉开口的限流性夹层；第3例患者出现穿刺部位血肿。术后靶病变的平均狭窄率立即从87.6±10.6%降至5.9±5.0%。共有35例（94.6%）患者出院时心肌缺血完全缓解。在44±32（范围6-112）个月的随访期间，无患者发生中风或心肌梗死。1例患者在36个月时发生支架再狭窄相关的不稳定型心绞痛，另1例患者在11个月时发生，2例患者均在球囊血管成形术后症状缓解，直至最后一次随访均无症状。
锁骨下动脉支架置入术治疗CSSS患者可行且安全，围手术期并发症发生率和支架再狭窄率低。©2017威利期刊公司
