[Prevertebral lesions of the subclavian artery: long-term results of reconstructive surgery and percutaneous angioplasty].

Short and long-term results were compared after reconstructive surgery and percutaneous transluminal angioplasty (PTA) of aortic arch trunks and subclavian arteries in 2 groups of patients (10 after dilatation and 12 after surgery). The technique used for treatment was selected as a function of distribution of lesions, their number and their appearance. Gruntzig's method was applied for PTA, while surgery consisted of either reimplantation of subclavian arteries into the main carotid artery or prosthetic by-pass procedures. Immediate and long-term (mean: 14 months) review examinations were by Doppler velocimetry and digital subtraction angiography. Thromboembolic complications secondary to PTA were not observed and there were no cases of recurrence of stenosis in the 10 patients after follow up for 13 months. Complications after surgery were one case of recurrence of stenosis requiring a repeat operation after 20 months, one case of thrombosis of carotid-axillary shunt after 19 months and one case of repeat surgery for lymphorrhea. Long-term results were very good in this series of 12 patients. It is difficult to compare results of the two techniques, patients treated by surgery having multiple lesions requiring combined procedures, and the number of cases treated being too low. However, PTA appears to be effective therapy for localized, non-ulcerated stenosis, and surgery for long or ulcerated stenosis, complete thrombosis and multiple lesions of aortic arch trunks justifying associated procedures.