Endovascular treatment of steno-occlusive lesions of subclavian arteries disease

Objective. The purpose of our study is to access the safety and efficacy of endovascular interventions for treatment of steno-occlusive disease of the subclavian artery. Methods. 205 patients with a steno-occlusive disease of the subclavian artery (SA) were included in this single-center retrospective study. 126 (61%) patients with stenosis of SA formed the 1st group, while 79 (39%) patients with SA occlusion made up the 2nd group. The treatment process was monitored intraoperatively by means of angiography, serial color Doppler ultrasonography of brachiocephalic vessels and complete neurological evaluation prior to discharge. The patients were then followed up over a period from 6 months to 5 years. Results. During the perioperative period one stroke (0.8%) in the vertebrobasilar basin was registered in the 1 st group. In the 2nd group one transient ischemic attack (1.2%) was observed. Re-interventions in the long-term period were carried out in 4 (3.1%) cases in the 1st group and 4 (5%) cases in the 2nd group (р = 0.419). The cumulative primary stent patency at 3 years was 96.7% in the 1st group and 94.1% in the 2nd group (р = 0.492). Conclusion. In the case of occlusion of the subclavian artery it could be appropriate to perform endovascular recanalization followed by stenting as the first stage of surgery. Endovascular treatment of lesions is an effective and safe method of prevention of stroke in the vertebrobasilar basin.