ATHEROSCLEROSIS OF THE SUBCLAVIAN ARTERY - INDICATIONS FOR SUBCLAVIANCAROTID TRANSPOSITION

Purpose. To analyze the clinical and anatomical outcome after subclavi an carotid transposition and to compare the results with other surgica l procedures. Methods. The hospital records of 51 patients undergoing subclavian carotid transposition were reviewed retrospectively for pre operative symptoms, Doppler and arteriography findings, preoperative d etails and postoperative complications. Long-term patency and symptoms were determined by physical and Doppler examination during the follow -up. Results. The indications for subclavian transposition were: verte brobasilar ischemia (24 %), ischemia of the upper limb (45 %), asympto matic occlusion or non-specific symptoms (31 %). Subclavian artery tra nsposition was associated with vertebral revascularization (7 cases), and homolateral carotid surgery (11 cases). There were no deaths. Earl y occlusions occurred in two cases, one required reoperation. Minor co mplications were observed in 21% of the patients with no permanent mor bidity. Overall patency after a mean 54 months follow-up was 96 %. Con clusion. Subclavian carotid transposition is a good method for the tre atment of proximal subclavian occlusive disease. Long-term patency can be achieved. Carotido-subclavian bypass should be limited to cases wi th extensive occlusive lesions as patency rate is lower.