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Percutaneous Antegrade and Retrograde Endovascular approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up.
Heart Views 2019 Jul-Sep; 20(3):87-92HV

Abstract

Background and Purpose

Angioplasty and stenting of the subclavian artery have been reported with high technical and clinical success rates, low complication rates, and good midterm patency rates. Different antegrade or retrograde endovascular catheter-based approaches are used. Nowadays, endovascular therapy has taken over open surgical techniques in subclavian artery disease. The purpose of this study was to determine safety, efficacy, and midterm clinical and radiological outcome of the endovascular treatment with special focus on the different technical approaches in subclavian artery disease.

Materials and Methods

Between 2014 and 2017, 11 patients (10 men, 1 woman) with symptomatic high-grade stenosis (90%-100%) of the subclavian artery were treated with endovascular treatment. Their mean age was 51.3 years (range, 32-61 years). Mean angiographic and clinical follow-up was 22.5 months (range, 5-44 months). Clinical follow-up was performed at hospital discharge and routine follow-up was performed at 1, 3, 12 months, and 6 monthly thereafter. In all 11 patients, a percutaneous approach was used successfully. In eight patients, the lesions were accessed retrogradely through a brachial artery puncture.

Results

Acute success rate was 100%. There were no significant peri-procedure complications. At the latest clinical follow-up (mean of 22.5 months), all patients showed a good outcome with a restenosis rate of 18.2% including a patient with Takayasu arteritis.

Conclusion

Percutaneous antegrade and retrograde stenting of high-grade subclavian artery stenosis is a viable less invasive alternative to open bypass surgery with good midterm clinical results and patency rates.

Authors+Show Affiliations

Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31620253

Citation

Krishnappa, Santhosh, et al. "Percutaneous Antegrade and Retrograde Endovascular Approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up." Heart Views : the Official Journal of the Gulf Heart Association, vol. 20, no. 3, 2019, pp. 87-92.
Krishnappa S, Rachaiah JM, Hegde SS, et al. Percutaneous Antegrade and Retrograde Endovascular approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up. Heart Views. 2019;20(3):87-92.
Krishnappa, S., Rachaiah, J. M., Hegde, S. S., Sadananda, K. S., Nanjappa, M. C., & Ramasanjeevaiah, G. (2019). Percutaneous Antegrade and Retrograde Endovascular approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up. Heart Views : the Official Journal of the Gulf Heart Association, 20(3), pp. 87-92. doi:10.4103/HEARTVIEWS.HEARTVIEWS_31_18.
Krishnappa S, et al. Percutaneous Antegrade and Retrograde Endovascular Approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up. Heart Views. 2019;20(3):87-92. PubMed PMID: 31620253.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous Antegrade and Retrograde Endovascular approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up. AU - Krishnappa,Santhosh, AU - Rachaiah,Jayasheelan Mambally, AU - Hegde,Srinidhi S, AU - Sadananda,Kanchanahalli Siddegowda, AU - Nanjappa,Manjunath Cholenahally, AU - Ramasanjeevaiah,Govardhan, PY - 2019/10/18/entrez PY - 2019/10/18/pubmed PY - 2019/10/18/medline KW - Brachial artery KW - Takayasu arteritis KW - common femoral artery KW - percutaneous transarterial angioplasty KW - subclavian artery SP - 87 EP - 92 JF - Heart views : the official journal of the Gulf Heart Association JO - Heart Views VL - 20 IS - 3 N2 - Background and Purpose: Angioplasty and stenting of the subclavian artery have been reported with high technical and clinical success rates, low complication rates, and good midterm patency rates. Different antegrade or retrograde endovascular catheter-based approaches are used. Nowadays, endovascular therapy has taken over open surgical techniques in subclavian artery disease. The purpose of this study was to determine safety, efficacy, and midterm clinical and radiological outcome of the endovascular treatment with special focus on the different technical approaches in subclavian artery disease. Materials and Methods: Between 2014 and 2017, 11 patients (10 men, 1 woman) with symptomatic high-grade stenosis (90%-100%) of the subclavian artery were treated with endovascular treatment. Their mean age was 51.3 years (range, 32-61 years). Mean angiographic and clinical follow-up was 22.5 months (range, 5-44 months). Clinical follow-up was performed at hospital discharge and routine follow-up was performed at 1, 3, 12 months, and 6 monthly thereafter. In all 11 patients, a percutaneous approach was used successfully. In eight patients, the lesions were accessed retrogradely through a brachial artery puncture. Results: Acute success rate was 100%. There were no significant peri-procedure complications. At the latest clinical follow-up (mean of 22.5 months), all patients showed a good outcome with a restenosis rate of 18.2% including a patient with Takayasu arteritis. Conclusion: Percutaneous antegrade and retrograde stenting of high-grade subclavian artery stenosis is a viable less invasive alternative to open bypass surgery with good midterm clinical results and patency rates. SN - 1995-705X UR - https://www.unboundmedicine.com/medline/citation/31620253/Percutaneous_Antegrade_and_Retrograde_Endovascular_approach_to_Symptomatic_High-Grade_Subclavian_Artery_Stenosis:_Technique_and_Follow-Up L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31620253/ DB - PRIME DP - Unbound Medicine ER -