Why the study?
Does noninvasive screening accurately identify subclavian artery stenosis compared to arteriography in candidates for coronary bypass surgery?
Does noninvasive screening accurately identify subclavian artery stenosis compared to arteriography in candidates for coronary bypass surgery?
Noninvasive screening with bilateral arm blood pressure measurements can reliably identify subclavian artery stenosis in CABG candidates, avoiding the need for routine invasive arteriography.
May support bilateral arm BP screening for subclavian stenosis in CABG candidates; leaves open prospective validation versus arteriography.
We prospectively evaluated 59 patients who were deemed candidates for coronary bypass surgery after coronary artery angiography for subclavian artery narrowing, which could compromise the ipsilateral internal thoracic artery graft. Bilateral arm blood pressure (BP) measurements, auscultation for supraclavicular or cervical bruits, and questioning about cerebrovascular ischemic symptoms were compared to brachiocephalic-subclavian arteriography. One neurologic complication occurred during arteriography. An upper extremity BP difference of > or = 15 mm Hg identified all patients with > or = 50% subclavian artery narrowing. We recommend brachiocephalic-subclavian arteriography only in patients with abnormal noninvasive screening for subclavian stenosis, not routinely.
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Osborn et al. (2002) studied this question.
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