Percutaneous transluminal angioplasty in subclavian steal syndrome: recurrent stenosis and retreatment in two patients.

Two patients with proximal subclavian artery stenosis and "subclavian steal syndrome" by clinical and arteriographic criteria were treated with percutaneous transluminal balloon catheter angioplasty. Successful dilatation was obtained, but stenoses recurred at or near the dilated segments in both cases, necessitating repeat transluminal angioplasty. One patient eventually underwent surgical carotid-subclavian grafting. Factors influencing recurrent stenosis after transluminal angioplasty are discussed, including the choice of an optimal balloon inflation diameter, the pathophysiology of angioplasty, and the role of anticoagulation. Transluminal angioplasty may be a viable therapeutic alternative to operation in selected patients with occlusive subclavian disease.