Huanggu Haotian, Gu Guangchao, Li Fangda, Zeng Rong, Shao Jiang, Song Xiaojun, Liu Zhili, Zheng Yuehong
Department of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China.
Department of Vascular Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Sci Prog. 2025 Jan-Mar;108(1):368504241307470. doi: 10.1177/00368504241307470.
To explore the prevalence and risk factors of carotid artery (CA) stenosis among subclavian steal syndrome (SSS) patients and to record their prognoses.
This observational study was retrospective. From January 2015 to October 2022, 169 patients were diagnosed with SSS. Among them, 51 combined with CA stenosis have surgical indications for both diseases. In this cohort, 24 were treated for subclavian artery (23 endovascular, 1 open), 12 for CA (6 endovascular, 6 open), and 5 for both (1 endovascular, 1 open, 3 hybrid). The primary end point was mortality, and the secondary end points were vessel re-stenosis and other complications. Patients were followed up through outpatient, online, or telephone.
Compared with simple SSS, patients who suffered from both were older (60.51 ± 9.304 versus 66.69 ± 7.921, < 0.001) and more males (57.6% versus 86.3%, < .001). Besides, they presented a higher prevalence of hyperhomocysteinemia ( = .015), diabetes mellitus ( = .036), and CVA/TIA ( = .036). No patient died within 30 days after surgery; four complications occurred (1 stroke, 1 hearing loss, 1 TIA, 1 infection). During a median follow-up of 37.6 months, two patients died without relation to the operation, three appeared in-stent restenosis, and one developed contrast nephropathy.
This study observed and analyzed different intervention methods and their prognosis in SSS combined with CA stenosis patients, and due to the limited number of participants, more data support would be needed.
The management of SSS patients combined with CA stenosis is more challenging compared to simple SSS. Our research demonstrated different surgical methods and their prognosis.
探讨锁骨下动脉窃血综合征（SSS）患者颈动脉（CA）狭窄的患病率及危险因素，并记录其预后情况。
本观察性研究为回顾性研究。2015年1月至2022年10月期间，169例患者被诊断为SSS。其中，51例合并CA狭窄且两种疾病均有手术指征。在该队列中，24例接受了锁骨下动脉治疗（23例血管内治疗，1例开放手术），12例接受了CA治疗（6例血管内治疗，6例开放手术），5例接受了两种治疗（1例血管内治疗，1例开放手术，3例杂交手术）。主要终点为死亡率，次要终点为血管再狭窄及其他并发症。通过门诊、线上或电话对患者进行随访。
与单纯SSS患者相比，合并两种疾病的患者年龄更大（60.51±9.304岁对66.69±7.921岁，P<0.001），男性更多（57.6%对86.3%，P<0.001）。此外，他们高同型半胱氨酸血症（P=0.015）、糖尿病（P=0.036）和CVA/TIA（P=0.036）的患病率更高。术后30天内无患者死亡；发生了4例并发症（1例中风、1例听力丧失、1例TIA、1例感染）。在中位随访37.6个月期间，2例患者非手术相关死亡，3例出现支架内再狭窄，1例发生造影剂肾病。
本研究观察并分析了SSS合并CA狭窄患者的不同干预方法及其预后，由于参与者数量有限，需要更多的数据支持。
与单纯SSS相比，SSS合并CA狭窄患者的管理更具挑战性。我们的研究展示了不同的手术方法及其预后。
