Percutaneous transluminal angioplasty of the subclavian artery

张青　金征宇　杨宇　刘巍　
潘杰　黄一宁　高山　戴建平

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ABSTRACT

Objective：To evaluate the effect and safety of percutaneous transluminal angioplasty(PTA) of subclavian artery. Methods :76 patients with severe stenosis or total occlusion of subclavian artery were treated with PTA. Symptoms of vertebrobasilar and (or) upper extremity arterial insufficiency were present in all patients. Digital subtraction angiography (DSA) showed that 69 had severe stenosis and 7 had total occlusion of the subclavian artery before PTA. 68 lesions were successfully dilate and stents were implanted in other 8 lesions. Results: The symptoms disappeared or alleviates obviously in all patients after PTA. DSA and transcranial Doppler ultrasonography (TCD) confimed that subclavian steal was corrected in 45 patients. There were only 3 minor-complications (2 pescudoaneurysms at puncture site, 1 transient dizziness during PTA) .During the follow-up of 4 to 35 months (average 29 months) , there were only three re-stenosis.
Conclusion: PTA is an effective and safe method to treat severe stenosis or total occlusion of subclavian artery. The rate of complications was lower than that of operative treatment.
　　Key words: Angioplasty; Subclavian artery; Arterial occlusive disease 
Qing Zhang, Zhengyu Jin,Yu Yang, et al. Department of radiology, Beijing Union Hospital, Chinese Academy of Medical Sciences, Beijing Union Medical College, Beijing 100730, China
　　自1964年Dotter等[1]首次报道经皮腔内血管成形术（PTA）以来，随着球囊扩张导管的不断改进，PTA已被广泛应用于治疗动脉粥样硬化疾病。1980年Kerber等[2]首次成功地扩张了颈内动脉狭窄，但因可能发生脑动脉栓塞，PTA对于治疗主动脉弓上区域血管（锁骨下动脉、颈动脉）的疗效任存在争议。笔者对76例锁骨下动脉狭窄或闭塞患者进行了锁骨下动脉成形术，取得了满意效果。

材料与方法

1、 临床资料：自1994年2月至2000年8月对76例锁骨下动脉病变的患者行PTA治疗。锁骨下动脉狭窄69例（90.8%），其中左侧狭窄45例，右侧狭窄24例；完全闭塞7例（9.2%）,其中左侧闭塞6例，右侧闭塞1例。患者年龄45-72岁，平均58.7岁，男61例，女15例。行单纯球囊扩张术68例，放置支架8例。