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锁骨下动脉狭窄和闭塞的血管内治疗:一项单中心回顾性研究

Endovascular Treatment for Subclavian Artery Stenosis and Occlusion: A Single-Center Retrospective Study.

作者信息

Van Nut Lam, Vinh Pham Xuan, Vuong Nguyen Lam

机构信息

Department of Vascular Surgery, Cho Ray Hospital, Ho Chi Minh City, VNM.

Thoracic and Vascular Department, Thu Duc City Hospital, Ho Chi Minh City, VNM.

出版信息

Cureus. 2023 Sep 5;15(9):e44699. doi: 10.7759/cureus.44699. eCollection 2023 Sep.

Abstract

BACKGROUND

Subclavian artery stenosis and occlusion are common arterial diseases in the upper extremities, with atherosclerosis being the main cause. Endovascular treatment has emerged as a promising alternative to open surgical repair, but data are limited. This study aimed to evaluate the safety and effectiveness of endovascular procedures in the treatment of subclavian artery lesions at a tertiary vascular center in Vietnam.

METHODS

A retrospective analysis was conducted on patients who underwent endovascular treatment for symptomatic subclavian artery stenosis or occlusion between October 2013 and April 2022. Clinical characteristics, procedural details, short- and long-term outcomes, and patency rates were assessed.

RESULTS

Twenty-five patients were included in the study, with a mean age of 56.8 years. The majority of patients had risk factors for atherosclerosis, and all presented with symptoms related to subclavian artery disease. The endovascular procedures were successful in 96% of cases, with a low complication rate of 8%. During a median follow-up of 43 months, the overall patency rate was 92% at three years.

CONCLUSION

Endovascular treatment of subclavian artery stenosis and occlusion is a safe and effective option, with excellent long-term patency rates. These findings support the use of percutaneous revascularization as the first-line therapy, particularly in experienced centers. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these results.

摘要

背景

锁骨下动脉狭窄和闭塞是上肢常见的动脉疾病,动脉粥样硬化是主要病因。血管内治疗已成为开放性手术修复的一种有前景的替代方法,但相关数据有限。本研究旨在评估在越南一家三级血管中心进行血管内手术治疗锁骨下动脉病变的安全性和有效性。

方法

对2013年10月至2022年4月期间因有症状的锁骨下动脉狭窄或闭塞而接受血管内治疗的患者进行回顾性分析。评估临床特征、手术细节、短期和长期结果以及通畅率。

结果

25例患者纳入研究,平均年龄56.8岁。大多数患者有动脉粥样硬化危险因素,均表现出与锁骨下动脉疾病相关的症状。血管内手术96%成功,并发症发生率低,为8%。在中位随访43个月期间,三年时总体通畅率为92%。

结论

血管内治疗锁骨下动脉狭窄和闭塞是一种安全有效的选择,长期通畅率良好。这些发现支持将经皮血管重建作为一线治疗方法,尤其是在有经验的中心。需要进行更大样本量和更长随访期的进一步研究来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b90b/10552060/23bdb4dd74ee/cureus-0015-00000044699-i01.jpg

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