Schardey H M, Meyer G, Rau H G, Gradl G, Jauch K W, Lauterjung L
Department of Surgery, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany.
Eur J Vasc Endovasc Surg. 1996 Nov;12(4):431-6. doi: 10.1016/s1078-5884(96)80009-8.
To analyse the clinical results and long-term patency rates of 108 patients with subclavian carotid transposition (SCT) and compare the outcomes to other clinical series using the same technique, as well as to those reported for other surgical procedures and PTA in the treatment of proximal subclavian artery disease.
The hospital records of 108 patients with carotid subclavian transposition were retrospectively reviewed for preoperative symptoms, Doppler examination, arteriography, blood pressure differentials and postoperative complications. Long-term patency and symptoms were determined during a follow-up examination including a history, physical examination, blood pressure differentials, Doppler examinations and arteriography in selected cases.
The indication for SCT were subclavian steal (78%), upper extremity ischaemia (59%), rest pain or acral necrosis (5%), vertigo (6%). There was no mortality, blood pressure differentials were equalised in all patients without any early reocclusions. The complication rate was 15% with a permanent morbidity of 3%. Eighty-four patients (77%) could be re-examined during follow-up. For them the overall patency after a mean observation period of 70 months (1-144 months) was 100%.
Subclavian carotid transposition is an excellent method for the treatment of proximal subclavian occlusive disease because of its exceptional long-term patency and low morbidity.
分析108例行锁骨下动脉 - 颈动脉转位术（SCT）患者的临床结果和长期通畅率，并将结果与使用相同技术的其他临床系列进行比较，同时与报道的其他治疗锁骨下动脉近端疾病的外科手术和经皮腔内血管成形术（PTA）的结果进行比较。
回顾性分析108例行颈动脉 - 锁骨下动脉转位术患者的医院记录，包括术前症状、多普勒检查、血管造影、血压差异和术后并发症。在随访检查中确定长期通畅情况和症状，随访检查包括病史、体格检查、血压差异、多普勒检查以及在特定病例中进行血管造影。
SCT的适应症为锁骨下动脉窃血（78%）、上肢缺血（59%）、静息痛或肢端坏死（5%）、眩晕（6%）。无死亡病例，所有患者的血压差异均得到平衡，且无早期再闭塞情况。并发症发生率为15%，永久性致残率为3%。84例患者（77%）在随访期间接受了复查。对他们而言，平均观察期70个月（1 - 144个月）后的总体通畅率为100%。
锁骨下动脉 - 颈动脉转位术是治疗锁骨下动脉近端闭塞性疾病的一种极佳方法，因其具有出色的长期通畅率和低发病率。
