Objective: To determine the safety and clinical efficacy of endovascular procedures in treatment of total subclavian artery occlusion.
Methods: The clinical data of 32 patients with total subclavian artery occlusion undergoing endovascular treatment from April 2013 to June 2019 were reviewed. The surgical success rate, complications and follow-up results of the patients were analyzed.
Results: Endovascular procedures were performed via a femoral artery approach (17 cases), brachial artery approach (1 case) and combined femoral/brachial approach (14 cases) in the 32 patients, and stents were successfully placed in 26 patients (81.25%), including balloon-expandable stent in 15 cases and self-expandable stent in 11 cases. The symptoms of patients were obviously relieved after stenting. Six patients underwent bypass operation or conservative treatment after failure of recanalization of the occlusion. During operation, dissection of the subclavian artery occurred in 2 cases, vagal reflex occurred in one case and femoral artery pseudoaneurysm occurred in one case, and no cerebrovascular complications occurred. In the 26 patients undergoing stent placement, 24 cases were followed up for (34.6±4.2) months, and the cumulative 1-, 3- and 5-year primary patency rates were 92.31%, 80.77% and 73.08%, respectively.
Conclusion: Endovascular treatment for total occlusion of the subclavian artery is safe and effective, and it offers relatively high mid- and long-term patency rates. In patients with vertebral artery involvement, a self-expandable stent is strongly recommended to be used.