Coronary-subclavian steal syndrome: treatment with percutaneous transluminal angioplasty and stent placement

Abstract

The aim of this study was to assess the efficacy of percutaneous transluminal angioplasty (PTA) and stenting in the management of the coronary-subclavian steal syndrome (CSSS). A 56-year-old man presented with CSSS due to occlusion of the left subclavian artery. He was treated with PTA and placement of two stents in the left subclavian artery. Systolic blood pressure became equal in both arms and dizziness disappeared. There were no complications. Percutaneous transluminal angioplasty and stenting can effectively and safely manage CSSS.

Percutaneous Angioplasty of the Subclavian Artery in Patients with Mammary‐Coronary Bypass Grafts

“…Complications associated with endovascular treatment occur in 5–14% of cases and are generally minor compared with those of surgical treatment; these include: hematoma of the puncture site, thrombosis, arteritis, and pseudoaneurysm. Both intimal dissection of the vessel at the dilation site and embolization through the vertebral artery with neurologic deficit are generally transient 14–18 . The availability of different types and sizes of peripheral stents allows a prompt and effective restoration of blood flow after subclavian artery dissection.…”

Treatment of subclavian steal syndrome with percutaneous transluminal angioplasty and stenting: case report

“…There are still some doubts about the best management for the angiographic phenomenon of subclavian steal. However, when the phenomenon is associated with clinical manifestations such as dizziness, vertigo, ataxia, visual disturbances, motor deficits, focal seizures, confusion or syncope, some authors have recommended treatment for the symptomatic SA with PTA and/ or stenting 1,5,13 .…”

Percutaneous transluminal laser guide wire recanalization of chronic subclavian artery occlusion in symptomatic coronary-subclavian steal syndrome

“…Traditional surgical treatment with carotid-subclavian bypass or subclavian-carotid transposition has been replaced widely in recent years by percutaneous tech- niques, because of similar success rates and fewer complications [3,7]. Thus, transluminal therapy by PTA and adjunctive stent placement has evolved as the first-line treatment for subclavian artery stenosis.…”

“…In our case, there were also no complications during the subsequent PTA. These complications are rare and may include dissection, hematoma formation or thrombosis of the vascular access site, re-occlusion, and distal embolization [1,[7][8][9]. Vertebral embolic complications and subsequent stroke, with an overall incidence of about 1% [1], are major concerns of subclavian PTA.…”