STENTING FOR OCCLUSION OF THE SUBCLAVIAN ARTERIES - TECHNICAL ASPECTSAND FOLLOW-UP RESULTS

We report the results of stenting in 17 patients who underwent treatme nt for fetal occlusions in the subclavian arteries between July 1991 a nd December 1995. Fourteen of the lesions were located in the left sid e; 15 patients had a subclavian steal syndrome. The indications for tr eatment were vertebrobasilar insufficiency (n=7); arm claudication (n= 5); vertebrobasilar insufficiency and upper-limb ischemia (n=3); prote ction of a left internal mammary artery coronary bypass (n=7); and an isolated subclavian steal syndrome (n=1). A total of 23 stents were im planted in 17 patients; in 7 patient, 2 stents migrated during deploym ent, resulting in a 94% procedural success rate. One case of axillary thrombosis was successfully treated with local thrombolysis and balloo n angioplasty. There were no postprocedural neurologic complications o r deaths. Follow-up over a mean duration of 19.4 months (range, 4 to 5 6 months) revealed 1 asymptomatic restenosis at 5 months in a patient with 3 stents. Life-table analysis showed an 81% cumulative patency ra te at 6 months. We conclude that stenting for occlusion of the subclav ian arteries appears feasible and safe; however, further evaluation in a larger group of patients is needed to confirm these results.