[Percutaneous transluminal angioplasty in the treatment of occlusion of the subclavian artery. Preliminary results]. FT L'impiego dell'angioplastica percutanea transluminale nel trattamento delle steno-occlusioni dell'arteria succlavia. Risultati preliminari.

BACKGROUND AND AIMS: The authors examine the treatment of steno-occlusive diseases of the subclavian artery using transluminal percutaneous angioplasty in order to evaluate the correct indications and analyse the results. METHODS: The classic method was used according to Gruentzig's technique, following the surgical isolation of the brachial artery. All 15 patients (11 males, 4 females, mean age 64 years old) were suffering from stenosis of the subclavian ischemia during physical exercise (13), resting (2) or vertebrobasilar insufficiency. Diagnostic evaluation took the form of bilateral sphynghomanometric measurement, echo-Doppler of the cervico-brachial vessels when resting and during exercise, as well as selective arteriography in 13 cases. Intra- and postoperative arteriographic control was always performed and the method was declared successful if residual stenosis was less than 30% with a delta AP between the two lower limbs of less than 10 mmHg. Mean follow-up was 12 months. RESULTS: The immediate results included the onset of complications linked to hematoma of the arm and two small dissections of the subclavian artery which were treated conservatively. Residual stenosis, albeit not hemodynamically significant, appeared in 26.7% of patients (4 cases). One case of total occlusion without clinical symptoms and two non-hemodynamically significant re-stenoses were observed in the long term. CONCLUSIONS: The authors discuss the indications and results of this method and compare them with the data reported in the literature.