Immediate and long-term outcome of stenting of proximal parts of aortic arch branches


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Abstract

Complex clinical-ultrasound study was carried our in 29 patients before and after stenting of 29 subclavian arteries (SA) and 2 brachiocephalic trunks (BCT). In 28 cases damage of SA/BCT was presented as stenosis and in 3 cases as SA occlusion. Сlinical picture of vertebrobasilar insufficiency and/or upper limb ischemia took place in 97% of patients. Ultrasound diagnostics of aortic arch branches showed high informativity of the method in revealing the degree of the SA/BCT damage. Technical success was achieved in 94% of cases. Twenty seven (93%) patients were examined in dynamics, with average term of observation of 16 months [12, 30]. On color-coded duplex scanning, re-stenosis was detected in 18.5% of observations (5 patients). Re-stenosis was clinical asymptomatic in 3 of 5 patients. Smoking was found to be the only significant risk factor associated with re-stenosis.

 

About the authors

З. А. Suslina

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

A. O. Chechetkin

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

G. I. Kuntshevich

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

S. I. Skrylev

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

S. V. Protsky

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

A. Yu. Koshcheev

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

V. L. Shchipakin

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

O. V. Lagoda

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

A. V. Krasnikov

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

References

  1. Верещагин Н.В. Патология вертебрально-базилярной системы и нарушения мозгового кровообращения. М.: Медицина, 1980.
  2. Волков С.В., Антонов Г.И., Лазарев В.А. и др. Баллонная ангиопластика и стентирование при стенотических поражениях брахиоцефальных артерий. http://www.neuro.neva.ru/Russian/Issues/Articles_1_2006/2003.files/ 06.htm.
  3. Кавтеладзе З.А., Артамонова Ю.В., Бабунашвили А.М. и др. Ангиопластика и эндопротезирование стенотических поражений подключичных артерий. Междунар. журн. интервенционной кардиоангиологии. (Тез. III Рос. съезда интервенционных кардиоан- гиологов). М.: 2008; 14: 43–44.
  4. Покровский А.В., Калинин А.А. Хроническая ишемия верхних конечностей. В кн.: Покровский А.В. (ред.) Клиническая ангиология. Т. 2. М.: Медицина, 2004: 287–295.
  5. Amor M., Eid-Lidt G., Chati Z., Wilentz J. Endovascular treatment of the subclavian artery: stent implantation with or without predilatation. Catheter Cardiovasc. Interv. 2004; 63: 364–370.
  6. Bates M., Broce M., Lavigne P., Stone P. Subclavian artery stenting: factors influencing long-term outcome. Catheter Cardiovasc. Interv. 2004; 61: 5–11.
  7. Broadbent L., Moran Ch., Cross D., Derdeyn C. Management of ruptures complicating angioplasty and stenting of supraaortic arteries: report of two cases and a review of the literature. Am. J. Neuroradiol. 2003; 24: 2057–2061.
  8. Filippo F., Francesco M., Francesco R. et al. Percutaneous angioplasty and stenting of left subclavian artery lesions for the treatment of patients with concomitant vertebral and coronary subclavian steal syndrome. Cardiovasc. Intervent. Radiol. 2006; 29: 348–353.
  9. Hadjipetrou P., Cox S., Piemonte Th., Eisenhauer A. Percutaneous Revascularization of atherosclerotic obstruction of aortic arch vessels. JACC 1999; 33: 1238–1245.
  10. Henry M., Amor M., Henry I. et al. Percutaneous transluminal angioplasty of the subclavian arteries. J. Endovasc. Surg. 1999; 6: 33–41.
  11. Jagger J., Mathias D., Kempkes U. Bilateral subclavian steal syndrome: treatment with percutaneous transluminal angioplasty and stent placement. Ibid. 1994; 17: 328–332.
  12. Kablak-Ziembicka A., Przewlocki T., Pieniazek P. et al. Ultrasonography in suspected subclavian artery obstruction and in patient monitoring after subclavian stenting. Cardiovasc. Intervent. Radiol. 2007; 30: 894–900.
  13. Kandarpa K., Becker G., Hunink M. et al. Transcatheter interventions for the treatment of peripheral atherosclerotic lesions: part 1. J. Vasc. Interv. Radiol. 2001; 12: 683–695.
  14. Kumar K., Dorros G., Bates M. et al. Primary stent deployment in occlusive subclavian artery disease. Cathet. Cardiovasc. Diagn. 1995; 34: 281–285.
  15. Martinez R., Rodriguez-Lopez J., Torruella L. et al. Stenting for occlusion of the subclavian arteries. Technical aspects and follow-up results. Tex. Heart Inst. J. 1997; 24: 23–27.
  16. Päivänsalo M., Heikkilд O., Tikkakoski T. et al. Duplex ultrasound in the subclavian steal syndrome. Acta Radiol. 1998; 39: 183–188.
  17. Querd L., Criado F. The treatment of focal aortic arch branch lesions with Palmaz stent. J. Vasc. Surg. 1996; 23: 368–375.
  18. Reivich M., Holling H., Roberts B., Toole J. Reversal of blood flow through the vertebral artery and its effect on the cerebral circulation. N. Engl. J. Med. 1961; 265: 878-885.
  19. Rodriguez-Lopes J., Werner A., Martinez R. et al. Stenting for atherosclerotic occlusive disease of the subclavian artery. Ann. Vasc. Surg. 1999; 13: 254–260.
  20. Rogers C., Edelman E. Endovascular stent design dictates experimental restenosis and thrombosis. Circulation 1995; 91: 2995–3001.
  21. Sadato A., Satow T., Ishii A. et al. Endovascular recanalization of subclavian artery occlusions. Neurol. Med. Chir. 2004; 44: 447–453.
  22. Schillinger M., Haumer M., Schillinger S. et al. Risk stratification for subclavian artery angioplasty: is there an increased rate of restenosis after stent implantation? J. Endovasc. Ther. 2001; 8: 550–557.
  23. Schwend R., Hambsch K., Baker L. et al. Carotid steal syndrome: A case study. J. Neuroimaging 1995; 5: 195–197.
  24. Sheiban I., Dharmadhikari A., Melissano G. et al. Subclavian artery stenting: Immediate and mid term clinical follow-up results. Int. J. Cardiovasc. Intervent. 2000; 3: 231–235.
  25. Smith J., Koury H., Hafner C., Welling R. Subclavian steal syndrome – a review of 59 consecutive cases. J. Cardiovasc. Surg. 1994; 35: 11–14.
  26. Taylor R., Siddiq F., Suri M. et al. Risk factors for in-stent restenosis after vertebral ostium stenting. J. Endovasc. Ther. 2008; 15: 203–212.
  27. Tyagis S., Verna P., Gambhir D. et al. Early and long-term results of subclavian angioplasty in aortoarteriitis (Takaysu disease): comparison with atherosclerosis. Cardiovasc. Intervent. Radiol. 1998; 21: 219–224.
  28. Woo E., Fairman R., Velazquez O. et al. Endovascular therapy of symptomatic innominate-subclavian arterial occlusive lesions. Vasc. Endovasc. Surg. 2006; 40: 27–33.
  29. Yip P., Liu H., Hwang B., Chen R. Subclavian steal phenomenon: a correlation between duplex sonographic and angiographic findings. Neuroradiol. 1992; 34: 279–282.

Copyright (c) 2010 Suslina З.А., Chechetkin A.O., Kuntshevich G.I., Skrylev S.I., Protsky S.V., Koshcheev A.Y., Shchipakin V.L., Lagoda O.V., Krasnikov A.V.

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