鎖骨下動脈病変のIVR

抄録

Endovascular therapy (EVT) for subclavian artery disease (SCAD) has been shown to be effective and is widely used as first-line treatment. Additionally, endovascular techniques and devices have been advancing. Some studies have already shown that primary EVT for SCAD is safe with long-term durability. However, these are small samples. Here, a large-scale, multicenter retrospective study was performed to evaluate the safety and efficacy in 556 patients. From this database, procedure success was achieved in 96.8%. The perioperative complication rate was 9.2%. Stroke was found in 1.8%. Primary, assisted-primary and secondary patencies at 3 years were 83.2±1.8%, 91.5±1.3% and 98.2±0.6%, respectively. There was no significant difference in primary patency between stenosis and occlusive lesions. On multivariate analysis, critical hand ischemia, cerebrovascular disease, current smoker, lesion length, and, the use of intravascular ultrasound were independent predictors of primary patency. The 3-year overall survival was 86.7%. There were 89 deaths during follow-up. Of them, cardiovascular death accounted for 49%. Finally, primary EVT for SCAD seemed to achieve acceptable outcomes regarding perioperative complication and long-term patency.