Symptomatic subtotal occlusion of the innominate artery treated with balloon angioplasty and stenting

Purpose: To report the endovascular treatment of a subtotal occlusion of th e innominate artery giving rise to subclavian steal syndrome. Methods and Results: A 60-year-old man in general good health was admitted to the hospital for sudden onset of amaurosis in the right eye. Thrombosis of the central retinal artery was diagnosed. Physical examination, color fl ow duplex imaging, and aortic arch angiography showed a subtotal occlusion of the innominate artery with right subclavian steal syndrome. One month la ter, balloon dilation and stenting of the innominate artery was performed t hrough a right axillary access without cerebral protection. The innominate artery was recanalized with correction of the steal syndrome and restoratio n of the right radial pulse; no complications occurred. Twelve months later , color flow duplex sonography confirmed innominate stent patency and anteg rade flow in the right vertebral artery. Conclusions: Our experience supports the view that percutaneous endovascula r techniques are appropriate and are the preferred treatment for lesions of the supra-aortic vessels. Continued surveillance will determine their long -term durability.