Subclavian artery stenting for coronary-subclavian steal syndrome.

Abstract

OBJECTIVES:

To evaluate the safety and feasibility of subclavian artery stenting for coronary-subclavian steal syndrome (CSSS).

BACKGROUND:

CSSS is a rare cause of myocardial ischemia due to ipsilateral subclavian artery stenosis in patients who have undergone coronary artery bypass graft. However, current knowledge of the optimal therapy for CSSS is limited.

METHODS:

The clinical data of 37 patients (33 male; mean age 65 ± 6 years) with CSSS who had undergone subclavian artery stenting between April 2007 and December 2015 were analyzed.

RESULTS:

The time elapsed between bypass surgery and the diagnosis of CSSS was 6.3 ± 4.3 years (median 5.2 years, range 1.3 months to 17.8 years). The technical success rate was 97.3% (100% for stenosis, 85.7% for occluded lesions). One patient experienced a transient ischemic attack; a second patient developed flow-limiting dissection involving the ostium of the internal mammary artery; and a third patient had a puncture site hematoma. The mean stenosis of target lesions decreased from 87.6 ± 10.6% to 5.9 ± 5.0% immediately after the procedure. A total of 35 (94.6%) patients were discharged with a complete remission of myocardial ischemia. During a follow-up of 44 ± 32 (range 6-112) months, no patient suffered from stroke or myocardial infarction. Stent-restenosis related unstable angina developing in one patient at 36 months and in another patient at 11 months, both of whom were relieved after balloon angioplasty and remained asymptomatic until the last follow-up.

CONCLUSION:

Subclavian artery stenting is feasible and safe in patients with CSSS, with a low incidence of perioperative complications and stent restenosis rate. © 2017 Wiley Periodicals, Inc.

• Authors: Wuqiang Che, Hui Dong, Xiongjing Jiang, Meng Peng, Yubao Zou, Lei Song, Huimin Zhang, Yuejin Yang, Runlin Gao
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 89 Issue S1 Pg. 601-608 (Mar 2017) ISSN: 1522-726X [Electronic] United States
• PMID: 28318140 (Publication Type: Journal Article)
• Copyright: © 2017 Wiley Periodicals, Inc.

Topics

• Aged
• Computed Tomography Angiography
• Coronary Artery Bypass (adverse effects)
• Coronary-Subclavian Steal Syndrome (diagnostic imaging, etiology, physiopathology, therapy)
• Endovascular Procedures (adverse effects, instrumentation)
• Feasibility Studies
• Female
• Humans
• Male
• Middle Aged
• Recurrence
• Retrospective Studies
• Stents
• Subclavian Artery (diagnostic imaging, physiopathology)
• Time Factors
• Treatment Outcome