Subclavean stenosis/occlusion in patients with subclavean steal and previous by pass of internal mammary interventricular anterior artery: medical or surgery treatment?

Salvatore Novo, Glauco Milio, Filippo Ferrara, Francesco Meli, Francesco Raimondi, Filippo Ferrara, Michele Antonio Cospite, Valentina Cospite

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    Abstract

    There are only a few published studies on the association between subclavian steal syndromeand ischemic heart disease. The objective of this report is to evaluate the efficacy of subclavianstenoocclusion treatment in patients with subclavian steal syndrome (SSS) and previous cor-onary bypass. Over the last 8 years we observed 207 patients who underwent left internalmammary artery–intraventricular artery (LIMA–IVA) bypass graft. Of these, 31 patients wereaffected by steno-occlusion of the homolateral subclavian artery. Ten patients (group 1) showedlatent vertebral-SSS and were pharmacologically treated. Seven patients (group 2) had anintermittent vertebral-SSS; four patients were treated with angioplasty and stent application andthree were pharmacologically treated. Fourteen patients (group 3) with complete vertebral-SSSwere treated with angioplasty and stent application or carotid-subclavian bypass graft. All pa-tients were followed up every 3 months for a period of 5 years after the diagnosis. The firstgroup of patients showed no angina and no sign of subclavian restenosis. In the second grouponly two patients, who were affected by angina, showed subclavian restenosis at angiography.In the third group only one patient underwent further angioplasty for restenosis. The results ofthis study show that the SSS may be an adverse event in patients with a LIMA-IVA bypass graft.Identification of the steal is essential to choose an appropriate therapeutic approac
    Original languageEnglish
    Pages (from-to)566-571
    Number of pages6
    JournalAnnals of Vascular Surgery
    Volume18
    Publication statusPublished - 2004

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Cardiology and Cardiovascular Medicine

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