Early-Midterm Results of Surgical Revascularization Procedures for Subclavian Artery Occlusion
Cemalettin Aydın, Yasin Ay, İbrahim Kara, Bekir İnan, Halil Başel, Ahmet Çalışkan, Rahmi Zeybek
Keywords: Endovascular procedures, subclavian artery stenosis, vascular surgical procedures, vascular patency.
Introduction: Subclavian artery occlusion is of ten with underlying pathology of atherosclerosis. With the frequent use of endovascular interventions for treatment, surgery has been less preferred. The purpose of this study is to analyze early-mid term results of surgical revascularization procedures done for subclavian artery occlusion and the change of etiological factors over time. Patients and Methods: Fifty-four patients, who underwent surgery due to subclavian artery occlusion in our center between 2005-2011, were evaluated retrospectively. Early complications, midterm graft patency and change of etiologic factors over they ears were evaluated. Results: The early and the midterm mortality was not observed. Carotico-subclavian bypass and axillo-axillary bypass were the most commonly performed procedures and the midterm patencies were 92.3% and 68.4% respectively. For the iatrogenic subclavian artery occlusion group of patients after thoracic endovascular aortic repair, aorta-subclavian and carotico-subclavian bypass patency rates were 100%. Between 2005-2010, etiology in patients under going surgery for subclavian artery occlusion was atherosclerosis in 77.1% of all patients, vasculitis in 12.5% and embolism and trauma in 10.4%. In 2011, etiology in patients requiring surgery was iatrogenic occlusion caused by endovascular procedures in 66.7% of all patients and atherosclerosis in 33.3% of all patients. Conclusion: It was detected that because of increasing trend in percutaneus procedures, iatrogenenic subclavian artery obstructions caused by endovascular interventions is replaced with etiologic factors, such as atherosclerosis and vasculitis. When surgical revascularization is necessary, carotico-subclavian bypass seems to be more advantageous when midterm patency rates are considered