Application of subclavian-carotid transposition to patients with proximal subclavian artery occlusion unable to be intervened
- VernacularTitle:锁骨下动脉-颈总动脉转位术在不能介入治疗的锁骨下动脉近端闭塞患者中的应用
- Author:
Yuanrui GU
1
;
Yangxue SUN
1
;
Chen TIAN
1
;
Mingyao LUO
1
;
Kun FANG
1
;
Chang SHU
1
;
Chenxi OUYANG
1
Author Information
1. Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Subclavian-carotid transposition;
subclavian artery occlusion;
steal syndrome;
interventional therapy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(09):1005-1009
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of subclavian-carotid transposition (SCT) in treating patients with proximal subclavian artery occlusive diseases who were unable to be intervened, such as failure of intervention, congenital malformation and unwillingness to intervention. Methods A retrospective review of 19 patients with proximal subclavian artery occlusion who underwent SCT from May 2016 to December 2018 was done. There were 14 males and 5 females with an average age of 54.05±17.34 years. The advantages and disadvantages of SCT in the treatment of proximal subclavian artery occlusion were analyzed. Results All patients achieved immediate remission of symptoms after surgery. The stenosis degree of the proximal subclavian artery decreased from 100.0%±0.0% to 12.7%±10.1% after surgery. The average blood pressure difference between the unaffected side and the affected side decreased from 11.95±10.60 mm Hg to 0.89±5.75 mm Hg (P<0.01). Peripheral nerve injury occurred in 7 (36.8%) patients. The in-patient cost of subclavian artery occlusion patients who received subclavian artery interventional therapy in our hospital during the corresponding period was 3 392.12 yuan higher than that of the SCT group in average (if eliminating the patients whose cost was far from the average value, the cost of interventional therapy was 4 812.01 yuan higher than that of the SCT group in average). During 1-3 years' follow-up, 6 patients with neurological complication relieved. One- and three-year patency rates were 100.0%. No perioperative stroke, death or re-operation happened. Conclusion SCT is an ideal process for the patients with subclavian artery occlusion who cannot accept subclavian artery interventional therapy.
