Surgical outcomes of subclavian steal syndrome combined with carotid artery stenosis: A single-center retrospective observational study

Objective To explore the prevalence and risk factors of carotid artery (CA) stenosis among subclavian steal syndrome (SSS) patients and to record their prognoses. Methods This observational study was retrospective. From January 2015 to October 2022, 169 patients were diagnosed with SSS. Among them, 51 combined with CA stenosis have surgical indications for both diseases. In this cohort, 24 were treated for subclavian artery (23 endovascular, 1 open), 12 for CA (6 endovascular, 6 open), and 5 for both (1 endovascular, 1 open, 3 hybrid). The primary end point was mortality, and the secondary end points were vessel re-stenosis and other complications. Patients were followed up through outpatient, online, or telephone. Results Compared with simple SSS, patients who suffered from both were older (60.51 +/- 9.304 versus 66.69 +/- 7.921, P < 0.001) and more males (57.6% versus 86.3%, P < .001). Besides, they presented a higher prevalence of hyperhomocysteinemia (P = .015), diabetes mellitus (P = .036), and CVA/TIA (P = .036). No patient died within 30 days after surgery; four complications occurred (1 stroke, 1 hearing loss, 1 TIA, 1 infection). During a median follow-up of 37.6 months, two patients died without relation to the operation, three appeared in-stent restenosis, and one developed contrast nephropathy. Discussion This study observed and analyzed different intervention methods and their prognosis in SSS combined with CA stenosis patients, and due to the limited number of participants, more data support would be needed. Conclusions The management of SSS patients combined with CA stenosis is more challenging compared to simple SSS. Our research demonstrated different surgical methods and their prognosis.