Stent-graft therapy for subclavian artery aneurysms and fistulas: Single-center mid-term results

PURPOSE: To evaluate the potential of covered stents to replace surgery in the treatment of subclavian artery aneurysms and traumatic injuries. MATERIALS AND METHODS: Nine patients (five men, four women; age range, 20-8 3 years; mean, 54 years) with subclavian artery aneurysms (n = 5) or fistul as (n = 4) were treated with stent-grafts. All devices used were custom-mad e, consisting of polytetrafluoroethylene (PTFE)-covered Palmaz (n = 5), Wal lstent (n = 2), Z stents (n = 8), or a polyester-covered Z stent (n = 1). O ne patient was lost to follow-up after 2 months. All others were followed u p with clinical evaluation, computed tomography (CT), and/or ultrasound. RESULTS: All devices were deployed successfully with exclusion of the aneur ysms and fistulas, There mere two procedure-related complications (22%), co nsisting of groin pseudoaneurysms requiring surgical repair 3 and 9 days af ter the procedure. One of those patients required additional oral antibioti c therapy for a postsurgical groin wound infection. One patient developed a stenosis at 12 months, which required angioplasty, The stent-graft thrombo sed in one patient because of a kink 2 months after placement, which was su ccessfully treated by thrombolysis and placement of a Wallstent. The primar y and secondary patencies are 89% and 100%, respectively, after a mean foll ow-up of 29 months (2-66 mo). CONCLUSION: Mid-term results of stent-graft therapy of subclavian artery an eurysms and fistulas are encouraging, with low morbidity and excellent clin ical outcome.