Long-term results after percutaneous transluminal angioplasty of the subclavian artery

Abstract

Introduction. Subclavian steal syndrome is a clinical problem of great importance, in which chronic upper limb ischaemia can cause a deficit of blood supply to the brain. Nowadays surgery is the routine approach to the management of complete subclavian artery (SA) occlusion; in the case of stenosis endovascular procedure is preferable.
Material and methods. We treated 74 patients with percutaneous transluminal angioplasty (PTA) for SA stenosis in our Department in the years 1989–1998 (44 females, 30 male; age 20–71 years, mean 49 years). Good results after angioplasty were obtained in 69 patients (93.2%). Five patients (8.1%) had only a temporary improvement but they refused further procedures. Analysis of the long-term results after SA PTA was the aim of the study. Fifty-two patients were followed-up for 16 to 128 months (mean 51 months).
Results. Thirty-nine patients (75%) had clinical improvement and normal vertebral artery blood flow direction confirmed by duplex-doppler, as well as equal brachial pressures. None of the patients complained of any signs of chronic brain or hand ischaemia. During follow-up 8 patients (15.4%) were diagnosed with subclavian artery stenosis, however lesser than 50%, causing a difference of brachial pressure up to 20 mm Hg.