Percutaneous endovascular reconstruction of the subclavian artery and its branches

Purpose. Principles, methods and results of percutaneous therapy in acute and chronic vascular alterations of the subclavian artery and its branches. Material and Methods. 17 arteries in 15 patients have been treated. The patients suffered from stenoses (n=6), occlusions (n=7), aneurysms, (n=2) or acute hemorrhage (n=2). The lesions were located in the subclavian artery (n=8), the axillar artery (n=4) or the vertebral artery (n=5). In all cases the procedures were performed via via a transfemoral approach. Ballon angioplasty was employed in 13 cases, in 6 cases bare stents and in 4 cases grafted stents were implanted. In one case additionally local lysis was performed. Results. Primary technical success was achieved in all cases. No catheter complications did occur. In 13 Patients complete follow-up examinations could be performed. The life-threatening acute hemorrhages were stopped without recurrent bleeding. The aneurysms could be completely excluded without endoleaks. In 4 Patients of the stenosis-group re-stenosis occurred and following stent-implantation one occlusion after 6 months was observed. 8 patients are without clinical symptoms since the intervention. Conclusion. Stenotic and occlusive vascular alterations as well as aneurysms and the acute hemorrhage in supraaortic arteries can be effectively and safely treated by endovascular techniques using percutaneous groin access.