Left subclavian artery stenting: an option for the treatment of the coronary-subclavian steal syndrome.

Abstract

INTRODUCTION:

The subclavian steal syndrome is characterized by the vertebral artery flow inversion, due to a stenotic lesion in the origin of the subclavian artery. The Coronary-subclavian Steal Syndrome is a variation of the Subclavian Steal Syndrome and is characterized by inversion of flow in the Internal Thracic artery that has been used as conduct in a myocardial revascularization. Its diagnosis must be suspected in patients with difference in pulse and arterial pressure in the upper limbs, that present with angina pectoris and that have done a myocardial revascularization. Its treatment must be a surgical bypass or a transluminal angioplasty.

OBJECTIVE:

The objective is to show the left subclavian artery stenting as a safe and effective method to treat the coronary-subclavian steal syndrome.

METHODS:

Historical prospective, non-randomized trial, through revision of the hospital records of the patients treated with the stenting of the left subclavian artery, from January 2006 to September 2012.

RESULTS:

In the mentioned period, 4.291 miocardial revascularizations were performed with the use of the left mammary artery, and 16 patients were identified to have the Coronary-subclavian steal syndrome. All of them were submitted to endovascular treatment. The success rate was 100%; two patients experienced minor complications; none of them presented with major complications. Eleven of the 16 patients had ultrassonographic documentation of patent stent for at least one year; two patients lost follow up and other two died.

CONCLUSION:

The stenting of the left subclavian artery is a good option for the treatment of the Coronary-subclavian Steal Syndrome, with high level of technical and clinical success.

• Authors: Bruno Lorenção de Almeida, Antonio Massamitsu Kambara, Fabio Henrique Rossi, Samuel Martins Moreira, Eduardo Silva Jordao de Oliveira, Frederico Augusto de Carvalho Linhares Filho, Patrick Bastos Metzger, Aldo Zampieri Passalacqua
• Journal: Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular (Rev Bras Cir Cardiovasc) 2014 Apr-Jun Vol. 29 Issue 2 Pg. 236-40 Brazil
• PMID: 25140474 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Angioplasty, Balloon, Coronary (methods)
• Coronary Angiography
• Coronary-Subclavian Steal Syndrome (diagnostic imaging, therapy)
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Reproducibility of Results
• Risk Factors
• Stents
• Subclavian Artery (diagnostic imaging)
• Treatment Outcome