Wilms G, Baert A, Dewaele D, Vermylen J, Nevelsteen A, Suy R
Cardiovasc Intervent Radiol. 1987;10(3):123-8. doi: 10.1007/BF02577985.
Percutaneous transluminal angioplasty of 23 subclavian arteries was attempted in 22 patients. Dilatation was successful in 3 of 4 right subclavian artery stenoses and 18 of 19 left subclavian artery stenoses. The primary clinical indication was posterior fossa ischemia in 11 patients, upper limb ischemia in 14 and both symptoms in 6. In 2 patients, dilatation of an asymptomatic high-degree left subclavian artery stenosis was performed before coronary artery bypass surgery using the internal mammary artery. Eighteen patients on follow-up over 6-60 months (mean 25 months) are free of symptoms with equivalent systolic blood pressures in both arms. Three patients showed relapse of the stenosis after 8, 12, and 15 months; one was successfully treated with a second dilatation. Complications consisted of an occlusion at the left axillary artery puncture site and a distal embolus to a finger artery. Percutaneous transluminal angioplasty appears safe and efficient therapy for subclavian artery stenoses with excellent short- and long-term results.
对22例患者的23条锁骨下动脉进行了经皮腔内血管成形术。4例右侧锁骨下动脉狭窄中有3例、19例左侧锁骨下动脉狭窄中有18例扩张成功。主要临床指征为:11例患者有后颅窝缺血,14例有上肢缺血,6例两者症状均有。2例患者在使用乳内动脉进行冠状动脉搭桥手术前,对无症状的高度左侧锁骨下动脉狭窄进行了扩张。18例患者接受了6至60个月(平均25个月)的随访,均无症状,双臂收缩压相当。3例患者分别在8、12和15个月后出现狭窄复发;1例经再次扩张成功治疗。并发症包括左腋动脉穿刺部位闭塞和手指动脉远端栓塞。经皮腔内血管成形术对于锁骨下动脉狭窄似乎是一种安全有效的治疗方法,具有出色的短期和长期效果。