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Zhao TY, Xu GQ, Xue JY, Bai WX, Cai DY, Yang BW, Shi WY, Li TX, Gao BL. Significance of atherosclerotic plaque location in recanalizing non-acute long-segment occlusion of the internal carotid artery. Sci Rep 2024; 14:10945. [PMID: 38740919 DOI: 10.1038/s41598-024-61938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/11/2024] [Indexed: 05/16/2024] Open
Abstract
To investigate the significance of atherosclerotic plaque location in hybrid surgery comprising both endovascular recanalization approaches and carotid endarterectomy for symptomatic atherosclerotic non-acute long-segment occlusion of the internal carotid artery (ICA), 162 patients were enrolled, including 120 (74.1%) patients in the proximal plaque group and 42 (25.9%) in the distal plaque group. Surgical recanalization was performed in all patients, with successful recanalization in 119 (99.2%) patients in the proximal and 39 (92.9%) in the distal plaque group. The total successful recanalization rate was 97.5% (158/162) with a failure rate of 2.5% (4/162). Periprocedural complications occurred in 5 (4.2% or 5/120) patients in the proximal plaque group, including neck infection in two (1.7%), recurrent nerve injury in 1 (0.8%), and laryngeal edema in 2 (1.7%), and 2 (4.8%) in the distal plaque group, including femoral puncture infection in 2 (4.8%). No severe complications occurred in either group. Univariate analysis showed plaque location was a significant (P = 0.018) risk factor for successful recanalization, and multivariate analysis indicated that the plaque location remained a significant independent risk factor for recanalization success (P = 0.017). In follow-up 6-48 months after the recanalization surgery, reocclusion occurred in two (2.8%) patients in the proximal plaque group and 4 (13.3%) in the distal plaque group. In conclusion, although hybrid surgery achieves similar outcomes in patients with ICA occlusion caused by either proximal or distal atherosclerotic plaques, plaque location may be a significant risk factor for successful recanalization of symptomatic non-acute long-segment ICA occlusion.
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Affiliation(s)
- Tong-Yuan Zhao
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Gang-Qin Xu
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Jiang-Yu Xue
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Wei-Xing Bai
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Dong-Yang Cai
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Bo-Wen Yang
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Wei-Yu Shi
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Tian-Xiao Li
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
| | - Bu-Lang Gao
- Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
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Huang Y, Xie X, Huang G, Lu W, Hong S, Chen Y, Lin Y, Fu W, Hong X, Wang L. Long-term outcomes of endovascular therapy for right subclavian artery occlusive lesions: A multi-center experience. Vascular 2024:17085381241247613. [PMID: 38631687 DOI: 10.1177/17085381241247613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To review our multi-institutional experience with endovascular therapy for right subclavian artery occlusive disease and to evaluate the long-term outcomes. METHODS We retrospectively evaluated all patients with right subclavian artery stenosis and occlusive disease who underwent endovascular therapy between March 2014 and September 2022 at two institutions. Patient baseline demographics, lesion characteristics, treatment strategies, and in-hospital and follow-up outcomes were prospectively collected and retrospectively analyzed. RESULTS Between March 2014 and September 2022, 73 patients underwent endovascular treatment at the two institutions. The dominant cause of lesions in this cohort was atherosclerosis. Three different types of lesions were summarized, and the corresponding endovascular strategies were performed. 66 patients (90.4%) underwent successful endovascular treatment, and 62 patients (84.9%) underwent balloon-expandable stent deployment. The mean perioperative in-hospital stay was 4.0 days (range, 3-6 days). Two patients died due to myocardial infarction, and one died of cerebral hemorrhage resulting from a traffic accident within 30 days of the intervention. The median follow-up time was 31.6 months (range, 12-96 months). No complications, including death, stroke, stent fractures, or migration, were noted in any patient during the follow-up period. The overall complication rate was 7/73 (9.6%), and 5/7 (6.9%) of the complications required reintervention. CONCLUSIONS Endovascular treatment of right subclavian artery lesions is safe, effective, and technically achievable. The reasonable use of balloon-expandable stents can achieve satisfactory outcomes with accurate orientation and promising patency.
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Affiliation(s)
- Yulong Huang
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Xinsheng Xie
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Guoqiang Huang
- Department of Radiology, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Weifeng Lu
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Shichai Hong
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Yihui Chen
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Yue Lin
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Weiguo Fu
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
- Department of Vascular Surgery, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Xiang Hong
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
| | - Lixin Wang
- Department of Vascular Surgery, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, China
- Department of Vascular Surgery, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
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Mitsui N, Kinoshita M, Nakazawa J, Ozaki H, Kimura T. Filter-type Protection Device Retrieval Interfered by Deployed Stent during Subclavian Artery Stenosis Treatment: Case Report and Complication Avoidance Recommendation. NMC Case Rep J 2023; 10:279-283. [PMID: 37953908 PMCID: PMC10635904 DOI: 10.2176/jns-nmc.2023-0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/21/2023] [Indexed: 11/14/2023] Open
Abstract
Endovascular treatment is a standard procedure for subclavian artery stenosis or obstruction. However, great care should be taken to avoid embolic complications to the vertebral artery, and several methods have previously been reported. Hence, as surgical procedures become increasingly complicated, unintended issues may arise during treatment. Here, the authors report a case where the filter-type protection device was caught in the stent because the patient moved during treatment, leading to open surgery to recover the filter-type protection device. A 78-year-old female suffering from a left subclavian steal syndrome underwent stenting due to subclavian artery stenosis. The stenotic lesion was approached via the transfemoral route, and a filter-type protection device was advanced to the vertebral artery via the transbrachial route to prevent embolic complications. As the procedure was performed under local anesthesia, the patient moved during stent deployment proximally to the left vertebral artery origin, and the stent unintentionally advanced distally, covering the vertebral artery and obstructing the retrieval catheter for the filter-type protection device to advance. Failed attempts in recovering the filter-type protection device required open surgery for retrieval. Fortunately, there was no postoperative neurological and radiographic complication, ameliorating her chief complaint. The retriever catheter for the protection device should be advanced beyond the vertebral artery orifice just proximal to the protection device before stenting to avoid such complications while also thoroughly considering the type of anesthesia during treatment..
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Affiliation(s)
- Nobuyuki Mitsui
- Department of Neurosurgery, Japanese Red Cross Kitami Hospital, Kitami, Hokkaido, Japan
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Manabu Kinoshita
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Junji Nakazawa
- Department of Cardiovascular Surgery, Hokkaido Prefectural Kitami Hospital, Kitami, Hokkaido, Japan
| | - Hirokazu Ozaki
- Department of Neurosurgery, Japanese Red Cross Kitami Hospital, Kitami, Hokkaido, Japan
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Teruo Kimura
- Department of Neurosurgery, Japanese Red Cross Kitami Hospital, Kitami, Hokkaido, Japan
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George JM, Cooke PV, Ilonzo N, Tadros RO, Grossi RJ. Management of Innominate Artery Occlusion With Severe Left Common Carotid Artery Stenosis. Cureus 2021; 13:e19592. [PMID: 34926061 PMCID: PMC8671066 DOI: 10.7759/cureus.19592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/27/2022] Open
Abstract
Innominate artery occlusion is a rare entity, particularly when coupled with severe left common carotid artery stenosis. Innominate artery disease may present with varying degrees of symptomatology and can place patients at risk for both posterior fossa and hemispheric ischemic events. We present a symptomatic case of innominate artery occlusion with severe left common carotid disease. We reviewed the literature and current options for the treatment of innominate artery disease. The patient underwent successful hybrid repair with left carotid artery retrograde stenting and left carotid artery to right carotid artery bypass. She has been symptom and re-intervention free during her one-year follow-up. We describe a successful hybrid repair of symptomatic innominate artery occlusion with concomitant severe left carotid artery stenosis in a patient with a prohibitive open thoracic surgical risk.
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Affiliation(s)
- Justin M George
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Peter V Cooke
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Nicole Ilonzo
- Division of Vascular and Endovascular Surgery, Department of Surgery, Weill Cornell, New York, USA
| | - Rami O Tadros
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Robert J Grossi
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
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Subclavian Artery Stenting Under Cerebral Protection by Balloon-Guiding Catheter Inflation Inside the Aortic Arch at the Left Subclavian Artery Origin. Ann Vasc Surg 2021; 81:211-215. [PMID: 34775013 DOI: 10.1016/j.avsg.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND We describe a simple and novel technique for cerebral protection during left subclavian artery (SA) stenting by inflation of a balloon-guiding catheter inside the aortic arch at the SA origin. METHODS A total of 12 patients with left SA stenosis underwent SA stenting with inflation of a balloon-guiding catheter inside the aortic arch at the left SA origin between January 2020 and December 2020. The SA stenting procedures under proximal protection were retrospectively reviewed to assess ischemic complications, hyperintense spots on diffusion-weighted imaging (DWI), and flow direction of left vertebral artery (VA) during balloon-guiding catheter inflation using ultrasonography (US). RESULTS The success rate of the SA stenting procedure was 100% with no symptomatic ischemic complications. None of the 12 patients showed small hyperintense spots in DWI. In all patients, the left VA on US during balloon inflation showed retrograde blood flow. CONCLUSIONS The left VA on US had retrograde blood flow during inflation of the balloon-guiding catheter inside the aortic arch at the SA origin. Therefore, the proximal balloon protection inside the aortic arch at the SA origin is a simple and maybe a safe technique for cerebral protection during SA stenting.
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Transradial dual-balloon protection system for subclavian artery stenting: "Balloon Switching" technique and literature review. Eur J Radiol 2021; 143:109907. [PMID: 34438329 DOI: 10.1016/j.ejrad.2021.109907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Endovascular treatment for subclavian artery (SA) occlusive disease is well established; however, a potential risk remains for posterior circulation embolism, which can be life threatening. To reduce the risk of vertebral artery (VA) embolism, we have devised a transradial dual-balloon protection system referred to as the balloon switching technique. Herein, we describe a patient with left SA stenosis who successfully underwent SA stenting using the balloon switching technique. Case presentation A 79-year-old woman with left arm claudication was diagnosed with left subclavian steal syndrome due to severe stenosis of the proximal left SA. Endovascular revascularization using the balloon switching technique was employed. To obtain VA embolic protection during device advancement through the SA lesion, an 8F balloon-guiding catheter was inflated in the left SA at the level of the VA takeoff using the left transradial sheathless approach. A balloon-expandable stent was inflated in the SA lesion, followed by deflation of the balloon-guiding catheter. The stagnant left VA flow was flushed away toward the distal left SA. Following reinflation of the balloon-guiding catheter, the stent delivery system was deflated and removed. Floating debris in the SA proximal to the balloon-guiding catheter was adequately aspirated, followed by deflation of the balloon-guiding catheter. Left SA angiography showed successful revascularization, and postprocedural neuroimaging showed no evidence of ischemic stroke. CONCLUSIONS The balloon switching technique reduces the risk of VA embolism during left SA stenting via the transradial access. This method is a useful therapeutic option for patients with left SA occlusive disease.
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Chen DW, Gao YH, Shi J, Yin YW, Zhang WQ. Significance of hemodynamic assessment by pressure wire for endovascular therapy of subclavian steal syndrome. Interv Neuroradiol 2020; 26:321-328. [PMID: 31969074 DOI: 10.1177/1591019919897765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Subclavian steal syndrome results from hemodynamic impairment due to stenosis or occlusion of subclavian artery. Therefore, it is important for subclavian steal syndrome patients to assess hemodynamic status during endovascular therapy. METHODS Eleven subclavian steal syndrome patients undergoing endovascular therapy attended this study. Pressure wire was used to measure trans-stenosis pressure difference (ΔP). Digital subtraction angiography, Transcranial Doppler and Electronic sphygmomanometer were introduced to assess stenotic rate, steal grade and inter-arm systolic pressure difference, respectively. Clinical symptoms and restenosis were followed up after endovascular therapy. The associations of ΔP with stenotic rate, inter-arm pressure difference, steal degree, clinic symptoms and restenosis were analyzed in this paper. RESULTS Prior to the therapy, ΔP moderately correlated with stenotic rate (r = 0.757, p = 0.007) and inter-arm pressure difference (r = 0.701, p = 0.016). ΔP was ≥6 mmHg in all patients, and 6-9 mmHg for grade 1 steal and ≥10 mmHg for grade 2 and 3 steals. After the therapy, all patients had technique success, and 10 patients had clinic success, and 1 patient appeared restenosis. ΔP was ≤3 mmHg and steal disappeared in the patients with clinical success. ΔP was 18 mmHg and grade 3 steal still existed in one patient without clinical success. One patient with 1 mmHg of ΔP after therapy appeared restenosis in the follow-up. CONCLUSION The trans-stenosis pressure difference is closely related to steal degree and clinical symptoms. The measurement of hemodynamic status by pressure wire is very useful to guide endovascular therapy in subclavian steal syndrome patients. However, the restenosis may still occur, even though the hemodynamic impairment is improved.
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Affiliation(s)
- Da-Wei Chen
- Department of Neurology, Air Force Medical Center, PLA (People's Liberation Army), Beijing, China
| | - Yu-Hai Gao
- Department of Neurology, Zhejiang Hospital, Hangzhou, China
| | - Jin Shi
- Department of Neurology, Air Force Medical Center, PLA (People's Liberation Army), Beijing, China
| | - Yan-Wei Yin
- Department of Neurology, Air Force Medical Center, PLA (People's Liberation Army), Beijing, China
| | - Wei-Qing Zhang
- Department of Neurology, Air Force Medical Center, PLA (People's Liberation Army), Beijing, China
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Mansukhani NA, Miller KR, Havelka GE, Russell HM, Eskandari MK. Aorta-innominate bypass through ministernotomy. J Vasc Surg 2018; 68:607-610. [DOI: 10.1016/j.jvs.2018.01.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/16/2018] [Indexed: 10/28/2022]
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Hammami R, Charfeddine S, Elleuch N, Fourati H, Abid L, Kammoun S. An unusual cause of ischemia after coronary bypass grafting!! REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.repce.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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10
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Hammami R, Charfeddine S, Elleuch N, Fourati H, Abid L, Kammoun S. An unusual cause of ischemia after coronary bypass grafting!! Rev Port Cardiol 2017; 37:87.e1-87.e5. [PMID: 29275015 DOI: 10.1016/j.repc.2016.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/13/2016] [Accepted: 10/24/2016] [Indexed: 10/18/2022] Open
Abstract
Coronary subclavian steal syndrome is an uncommon cause of ischemia recurrence after coronary artery bypass grafting. Endovascular treatment of subclavian artery stenosis or occlusion is increasingly common and appears to offer a safe and effective alternative to surgical revascularization. We report a case of recurrent angina after coronary artery bypass grafting for critical subclavian artery stenosis. The anomalous origin of the vertebral artery from the aortic arch was an indication for endovascular treatment. We discuss the diagnostic difficulties and the management pitfalls of subclavian artery angioplasty in this syndrome.
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Affiliation(s)
- Rania Hammami
- Hedi Chaker Hospital, Cardiology Department, Sfax, Tunisia.
| | | | - Nizar Elleuch
- Habib Bourguiba Hospital, Vascular Surgery Department, Sfax, Tunisia
| | - Hela Fourati
- Hedi Chaker Hospital, Radiology Departement, Sfax, Tunisia
| | - Leila Abid
- Hedi Chaker Hospital, Cardiology Department, Sfax, Tunisia
| | - Samir Kammoun
- Hedi Chaker Hospital, Cardiology Department, Sfax, Tunisia
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Feasibility and Safety of Distal and Proximal Combined Endovascular Approach with a Balloon-Guiding Catheter for Subclavian Artery Total Occlusion. World Neurosurg 2017; 100:709.e5-709.e9. [DOI: 10.1016/j.wneu.2017.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/31/2017] [Accepted: 02/02/2017] [Indexed: 11/22/2022]
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Liu Y, Zhang J, Gu Y, Guo L, Li J. Clinical Effectiveness of Endovascular Therapy for Total Occlusion of the Subclavian Arteries: A Study of 67 Patients. Ann Vasc Surg 2016; 35:189-96. [DOI: 10.1016/j.avsg.2016.01.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/02/2015] [Accepted: 01/24/2016] [Indexed: 11/25/2022]
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Sakamoto S, Kiura Y, Okazaki T, Ichinose N, Kurisu K. Endovascular Stenting under Cardiac and Cerebral Protection for Subclavian Steal after Coronary Artery Bypass Grafting Due to Right Subclavian Artery Origin Stenosis. J Cerebrovasc Endovasc Neurosurg 2015; 17:27-31. [PMID: 25874182 PMCID: PMC4394116 DOI: 10.7461/jcen.2015.17.1.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/28/2015] [Accepted: 02/04/2015] [Indexed: 11/23/2022] Open
Abstract
Coronary-subclavian steal (CSS) can occur after coronary artery bypass grafting (CABG) using the internal thoracic artery (ITA). Subclavian artery (SA) stenosis proximal to the ITA graft causes CSS. We describe a technique for cardiac and cerebral protection during endovascular stenting for CSS due to right SA origin stenosis after CABG. A 64-year-old man with a history of CABG using the right ITA presented with exertional right arm claudication. Angiogram showed a CSS and retrograde blood flow in the right vertebral artery (VA) due to severe stenosis of the right SA origin. Endovascular treatment of the right SA stenosis was planned. For cardiac and cerebral protection, distal balloon protection by inflating a 5.2-F occlusion balloon catheter in the SA proximal to the origin of the right VA and ITA through the right brachial artery approach and distal filter protection of the right internal carotid artery (ICA) through the left femoral artery (FA) approach were performed. Endovascular stenting for SA stenosis from the right FA approach was performed under cardiac and cerebral protection by filter-protection of the ICA and balloon-protection of the VA and ITA. Successful treatment of SA severe stenosis was achieved with no complications.
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Affiliation(s)
- Shigeyuki Sakamoto
- Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Yoshihiro Kiura
- Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Takahito Okazaki
- Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Nobuhiko Ichinose
- Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Kaoru Kurisu
- Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
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Madassery S, Souman T, Arslan B, Turba U. Subclavian Artery Chronic Total Occlusion (CTO) Recanalization Using the Truepath Device. EJVES Short Rep 2015. [DOI: 10.1016/j.ejvssr.2015.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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15
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Bangard C, Franke M, Maintz D, Chang DH. True lumen reentry with the OUTBACK catheter in chronic occlusions of the subclavian artery. J Vasc Interv Radiol 2014; 25:1646-8. [PMID: 25255951 DOI: 10.1016/j.jvir.2014.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 04/18/2014] [Accepted: 04/18/2014] [Indexed: 11/27/2022] Open
Affiliation(s)
- Christopher Bangard
- Department of Radiology, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany
| | - Mareike Franke
- Department of Radiology, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany
| | - David Maintz
- Department of Radiology, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany
| | - De-Hua Chang
- Department of Radiology, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany
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Shinozaki N, Suzuki T, Ikari Y. Effective emergent endovascular recanalization for acute coronary syndrome with left subclavian artery occlusion in a prior coronary artery bypass graft patient. Cardiovasc Interv Ther 2014; 29:368-71. [PMID: 24399502 DOI: 10.1007/s12928-013-0242-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/27/2013] [Indexed: 11/28/2022]
Abstract
A 78-year-old female was hospitalized because of multiple bone fracture caused by falling down. She undertook coronary artery bypass graft (CABG) using left internal mammary artery (LIMA) about 10 years ago. She complained chest pain on the day of admission with hypotension. Emergent angiogram revealed total occlusion of left subclavian artery (SCA). We re-canalized left SCA with stent. Hemodynamics and symptom dramatically improved after the procedure. Acute coronary syndrome due to SCA occlusion after CABG using LIMA was rare, but we have to consider the possibility. Endovascular therapy to SCA lesion might be a proper strategy for these cases.
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Affiliation(s)
- Norihiko Shinozaki
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan,
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