Endovascular treatment of subclavian steal syndrome – own experience
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 2
Abstract
Introduction. Subclavian steal syndrome (SSS) occurs when proximal part of one of the subclavian artery or brachio-cephalic trunk is significantly narrowed or obstruced. The disease is characterized by a wide range of symptoms of vertebrobasiliar insufficiency including: headache, dizziness, tinnitus, vertigo – a sudden falls (drop attacks), double vision, scotomata and confusion. Patients also reports the typical symptoms of upper limb ischemia as: coldness, numbness of fingers, tingling or pain which growing during the limb movement (claudicatio intermittens). Surgery techniques and endovascular procedures are approved methods of subclavian steal syndrome treatments.Aim. To evaluate effectiveness of subclavian steal syndrome (SSS) treatment with using endovascular techniques.Material and methods. Between 2004-2012 in the Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, 112 procedures expand/unblocking of the subclavian artery or brachiocephalic trunk-cephalic were performed in patients with SSS. 58 men and 54 women aged 47-84 years (mean – 61 years) were in the study group. The procedures were performed only in symptomatic patients – with confirmed deficit and symptoms of cerebral ischemia (89%), upper limb ischemia (8%), in 3% of procedures were performed due to symptoms of myocardial ischemia (patients after CABG surgery – coronal-subclavian steal syndrome). In 91% of cases treatment concerned lesions in the left subclavian artery, 9% of patients had lesions in brachiocephalic trunk or in the right subclavian artery.Results. Technical success was 94% (100% in case of artery stenosis, 91% in patients with artery occlusion). 9 (8%) patients had minor complications – groin hematomas which not required intervention (6 patinets) or pseudoaneurysms (3 patients), which were treated by percutaneous thrombin injection. There was 1 death due to haemorrhagic stroke 3 days after procedure.Conclusions. Endovascular treatment of changes in the aortic arch arteries causing subclavian steal syndrome is characterized by a high primary and secondary technical success rate and a low risk of complications and recurrences.
Authors and Affiliations
Michał Sojka, Anna Sojka, Tomasz Jargiełło, Krzysztof Pyra, Monika Miazga, Andrzej Wolski, Małgorzata Szczerbo-Trojanowska
Keywords
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