Keywords:
Vascular, Interventional vascular, Arteries / Aorta, MR-Angiography, CT-Angiography, Catheter arteriography, Stents, Recanalisation, Angioplasty, Obstruction / Occlusion, Dilatation
Authors:
B. Polanec1, S. Breznik2, A. Slanič3, J. Lučev3, J. Matela3; 1Pesnica/SI, 2Pernica /SI, 3Maribor/SI
DOI:
10.1594/ecr2013/C-1245
Purpose
Lesion of the subclavian/innominate artery is an important cause of extracranial cerebrovascular disease (1).
Symptomatic patients present with upper limb ischemia,
ischemia of the posterior cerebral circulation or both.
In case of innominate artery lesion ischemia of the anterior cerebral circulation can also occur (2).
Patients with isolated subclavian artery lesions are often asymptomatic because of the presence of rich collateral supply (2).
Innominate artery lesions are uncommon and represent small portion of aortic arch lesions.
The left subclavian artery is involved more often than the right (3,
4,
5,
6).
Surgical revascularization has been the treatment of choice for lesions involving the aortic arch branches.
Percutaneous therapy for lesions of these arteries may have several advantages over standard surgical therapy because of its minimally invasive nature and greater patient acceptance (7).
It is a safe and effective method for the treatment of the subclavian/innominate artery lesions and leads to symptom resolution in majority of patients (8).
Indications for endovascular treatment are vertebrobasilar ischemia,
upper limb ischemia,
digital embolization,
angina pectoris in patients with left internal mammary artery (LIMA) graft,
leg claudication in patients with axillo-femoral grafts and to increase inflow for scheduled operative procedure,
i.e.
LIMA graft,
axillo-femoral graft,
dialysis graft.
In case of innominate artery lesions additional indications are anterior cerebral ischemia and prior to ipsilateral carotid endarterectomy (7,
9,
10,
11).
Published studies report good initial and long-term results of endovascular treatment.
In our department percutaneous transluminal angioplasty (PTA) of aortic branches was introduced in the beginning of the 1990s.
The aim of our study was to retrospectively evaluate the initial and long-term success rate,
safety and efficacy of the endovascular treatment for short stenoses and longer lesions of subclavian and innominate arteries.
Results were compared with published data.