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Endovascular stenting for atherosclerotic subclavian artery stenosis in patients with other craniocervical artery stenosis

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Abstract

Atherosclerotic subclavian artery stenosis (SAS) accompanied with other craniocervical artery stenosis (OCAS) is not uncommon in practice. We sought to investigate the safety and efficacy of endovascular stenting for SAS in patients with OCAS. Between January 2004 and February 2012, 71 consecutive atherosclerotic SAS patients who underwent primary stenting in our medical center were included. The enrolled patients were divided into combined-SAS group (n = 51) and solitary-SAS group (n = 20) depending on the presence or absence of OCAS. Data of demographics, procedure, and the followed-up were retrieved and analyzed. The technical success rate was 95.8 %; the clinical success rate was 90.1 %. There was no catheter-related major stroke or death. The immediate outcomes had no statistical difference between groups. During a mean of 27 ± 20 months (range 2–88 months) followed-up, 7(10.3 %) restenosis and 12(17.6 %) clinical events were identified. The primary patency rate was 95.3, 84.9 and 84.9 % at 12, 24 months, and final followed-up respectively, which had no statistical difference between groups (odds ratio (OR), 2.60; 95 % confidence interval (CI), 0.54–12.53; P = 0.232). The overall clinical event-free survival rate was 93.5, 86.2 and 54.6 %, respectively, where the result of combined-SAS group was inferior to that of the solitary-SAS group (OR, 3.34; 95 % CI, 1.02–11.00; P = 0.047). Endovascular stenting was safe and feasible for atherosclerotic SAS in patients with OCAS, although the combined OCAS may have a significant influence on the long-term outcome. Further studies are warrant to investigate the effects of revascularization for multiple craniocervical artery stenoses on the cerebral hemodynamics and long-term outcomes.

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Acknowledgments

This study was supported in part by Nature Science Foundation of China (NSFC 30870847 to Xinfeng Liu, NSFC 81000501 to Dezhi Liu) and Jiangsu Nature Science Foundation (BK 2010067 to Wusheng Zhu).

Conflicts of interest

We have no conflicts of interest.

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Authors and Affiliations

  1. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China

    Yongkun Li, Qin Yin, Wusheng Zhu, Xiaobing Fan, Dezhi Liu, Maogang Chen, Gelin Xu & Xinfeng Liu

  2. Department of Neurology, Provincial Clinical Department of Fujian Medical University, Fuzhou, Fujian, China

    Yongkun Li & Yinzhou Wang

  3. Comprehensive Stroke Centre, Division of Neurosciences, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3050, Australia

    Bernard Yan

  4. Department of Neurology, The Affiliated Shenzhen Shajing Hospital of Guangzhou Medical University (Shajing People’s Hospital), Shenzhen, Guangdong, China

    Qizhang Wang

Authors
  1. Yongkun Li
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  2. Qin Yin
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  3. Wusheng Zhu
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  4. Yinzhou Wang
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  5. Xiaobing Fan
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  6. Dezhi Liu
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  7. Maogang Chen
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  8. Qizhang Wang
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  9. Gelin Xu
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  10. Bernard Yan
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  11. Xinfeng Liu
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Corresponding authors

Correspondence to Bernard Yan or Xinfeng Liu.

Additional information

Yongkun Li and Qin Yin are contributed equally to this study.

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Li, Y., Yin, Q., Zhu, W. et al. Endovascular stenting for atherosclerotic subclavian artery stenosis in patients with other craniocervical artery stenosis. J Thromb Thrombolysis 35, 107–114 (2013). https://doi.org/10.1007/s11239-012-0789-4

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  • DOI: https://doi.org/10.1007/s11239-012-0789-4

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