Key result
Subclavian carotid transposition yielded 10-year primary patency of 90%, compared to 66.7% for carotid subclavian bypass and 50% for subclavian-subclavian bypass.
Why the study?
What are the long-term patency rates and clinical outcomes of different surgical interventions (SCT, CSB, SSB) in patients with symptomatic occlusive subclavian artery disease?
Cohort (n=20)
No
What are the long-term patency rates and clinical outcomes of different surgical interventions (SCT, CSB, SSB) in patients with symptomatic occlusive subclavian artery disease?
Subclavian carotid transposition provides excellent and durable long-term patency compared to other surgical bypass options for symptomatic occlusive subclavian artery disease.
SCT may warrant consideration for durable patency in subclavian disease; leaves open need for randomized confirmation of superiority.
Background: In this study, we described the outcomes of the procedures including subclavian carotid transposition (SCT), carotid subclavian bypass (CSB) and subclaviansubclavian bypass (SSB). Methods: Between January 1999 and December 2009, the medical records of 20 patients (19 males, 1 female; mean age 58.5 years; range 46 to 73 years) undergoing surgical intervention for symptomatic occlusive subclavian artery disease in our clinic were retrospectively analyzed. Ten of these patients underwent SCT, six underwent CSB and four underwent SSB. All patients had symptoms of severe subclavian artery insufficiency and a significant decrease of >50 mmHg in systolic blood pressure on the affected side. The mean follow-up was 7.1±2.1 years (range, 2-10 years). Results: Immediate relief of symptoms was achieved in 100% of patients, with an early graft success (30-day patency) of 95%. As noted primary patency rates at 1, 5, and 10 years in SCT series were %100, %100, %90, in CSB series %100, %83.3, % 66.7, in SSB series %100, %50, %50 respectively. Conclusion: The comparison of the early and late postoperative results show that transposition of subclavian artery to carotid artery is a safe, effective and durable procedure in eligible patients.
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Faik Fevzi Okur (2012) conducted a cohort in symptomatic occlusive subclavian artery disease (n=20). Surgical interventions (subclavian carotid transposition, carotid subclavian bypass, subclavian-subclavian bypass) was evaluated on Primary patency rates at 1, 5, and 10 years. Subclavian carotid transposition yielded 10-year primary patency of 90%, compared to 66.7% for carotid subclavian bypass and 50% for subclavian-subclavian bypass.
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