Abstract 1786: Long-Term Durability of Endoluminal Stenting for Obstructive Lesions of the Subclavian Artery: Multicenter Registry in Japan
Background: Obstructive lesions of the subclavian artery can result in arm claudication, symptoms of subclavian steal.
Aim: To evaluate the safety, efficacy and durability of endovascular stenting for treating 405 obstructive lesions of subclavian artery.
Methods: We performed 405 cases of endoluminal stenting for 383 patients (272 males, 67±13 years). All procedures were performed with Palmaz stents (272 cases) and Wall stents (133 cases), 262 cases (64.7%) were used transradial approach. Indications for stenting were arm claudication in 219 cases, subclavian steal syndrome in 90 cases and myocardial ischemia secondary to compromised flow through internal mammary grafts in 74 cases.
Results: Procedural success (defined as abolition of pressure gradient across the aorta and subclavian artery and a residual diameter stenosis <20% without major complications was achieved in 380 patients (99.2%). Only one patient had a major complication (mediastinum hemorrhage due to subclavian artery rupture). Baseline diameter stenosis was reduced from 88.9% to 12.9±9.2%, mean systolic pressure difference was reduced 45.9 ± 14.8 mmHg to 4.7 ± 4.9 mmHg (p<0.01). There was no cerebral or distal embolization. In 320 of 383 patients (83.6%) we performed, follow-up angiography ranged from 6 months to 9 years (mean, 56.8 months). Primary angiographic patency at 5 years was 99% (only 3 restenosis: 1.0%).
Conclusions: Endoluminal stenting of the subclavian artery is safe and effective with high technical success and these clinical benefits are durable at least 5 years.