Martinez R, Rodriguez-Lopez J, Torruella L, Ray L, Lopez-Galarza L, Diethrich E B
Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix 85006, USA.
Tex Heart Inst J. 1997;24(1):23-7.
We report the results of stenting in 17 patients who underwent treatment for total occlusions in the subclavian arteries between July 1991 and December 1995. Fourteen of the lesions were located in the left side; 15 patients had a subclavian steal syndrome. The indications for treatment were vertebrobasilar insufficiency (n = 7); arm claudication (n = 5); vertebrobasilar insufficiency and upper-limb ischemia (n = 3); protection of a left internal mammary artery coronary bypass (n = 1); and an isolated subclavian steal syndrome (n = 1). A total of 23 stents were implanted in 17 patients; in 1 patient, 2 stents migrated during deployment, resulting in a 94% procedural success rate. One case of axillary thrombosis was successfully treated with local thrombolysis and balloon angioplasty. There were no postprocedural neurologic complications or deaths. Follow-up over a mean duration of 19.4 months (range, 4 to 56 months) revealed 1 asymptomatic restenosis at 5 months in a patient with 3 stents. Life-table analysis showed an 81% cumulative patency rate at 6 months. We conclude that stenting for occlusion of the subclavian arteries appears feasible and safe; however, further evaluation in a larger group of patients is needed to confirm these results.
我们报告了1991年7月至1995年12月期间接受锁骨下动脉完全闭塞治疗的17例患者的支架置入结果。其中14处病变位于左侧；15例患者患有锁骨下窃血综合征。治疗指征包括椎基底动脉供血不足（7例）；上肢间歇性跛行（5例）；椎基底动脉供血不足和上肢缺血（3例）；保护左乳内动脉冠状动脉搭桥术（1例）；以及孤立性锁骨下窃血综合征（1例）。17例患者共植入23枚支架；1例患者在支架置入过程中有2枚支架移位，手术成功率为94%。1例腋静脉血栓形成患者经局部溶栓和球囊血管成形术成功治疗。术后无神经并发症或死亡病例。平均随访19.4个月（4至56个月），发现1例植入3枚支架的患者在5个月时出现无症状再狭窄。生命表分析显示6个月时累积通畅率为81%。我们得出结论，锁骨下动脉闭塞的支架置入术似乎可行且安全；然而，需要在更大规模的患者群体中进行进一步评估以证实这些结果。
