Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
CardioVascular and Interventional Radiology
Erschienen in: CardioVascular and Interventional Radiology 5/2016

02.12.2015 | Clinical Investigation

Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Background and Purpose

Subclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD.

Materials and Methods

We searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model.

Results

A total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8 %, p = 0.007). Long-term primary patency rates (76.9 vs 79.6 %, p = 0.729) and symptom resolution rates (82.2 vs 73.0 %, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death.

Conclusion

Stent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Fields WS, Lemak NA. Joint study of extracranial arterial occlusion. VII. Subclavian steal—a review of 168 cases. JAMA. 1972;222(9):1139–43.CrossRefPubMed
2.
Bryan AJ, Hicks E, Lewis MH. Unilateral digital ischaemia secondary to embolisation from subclavian atheroma. Ann R Coll Surg Engl. 1989;71(2):140–2.PubMedPubMedCentral
3.
Sueoka BL. Percutaneous transluminal stent placement to treat subclavian steal syndrome. J Vasc Interv Radiol. 1996;7(3):351–6.CrossRefPubMed
4.
Olsen CO, Dunton RF, Maggs PR, Lahey SJ. Review of coronary-subclavian steal following internal mammary artery-coronary artery bypass surgery. Ann Thorac Surg. 1988;46(6):675–8.CrossRefPubMed
5.
Edwards WH, Mulherin JL Jr. The surgical reconstruction of the proximal subclavian and vertebral artery. J Vasc Surg. 1985;2(4):634–42.CrossRefPubMed
6.
Wylie EJ, Effeney DJ. Surgery of the aortic arch branches and vertebral arteries. Surg Clin North Am. 1979;59(4):669–80.CrossRefPubMed
7.
AbuRahma AF, Bates MC, Stone PA, Dyer B, Armistead L, Scott Dean L, Scott Lavigne P. Angioplasty and stenting versus carotid-subclavian bypass for the treatment of isolated subclavian artery disease. J Endovasc Ther. 2007;14(5):698–704.CrossRefPubMed
8.
Bachman DM, Kim RM. Transluminal dilatation for subclavian steal syndrome. AJR Am J Roentgenol. 1980;135(5):995–6.CrossRefPubMed
9.
Joseph S, Mandalam KR, Rao VR, Gupta AK, Unni NM, Rao AS, Neelakandhan KS, Unnikrishnan M, Sandhyamani S. Percutaneous transluminal angioplasty of the subclavian artery in nonspecific aortoarteritis: results of long-term follow-up. J Vasc Interv Radiol. 1994;5(4):573–80.CrossRefPubMed
10.
Mathias KD, Luth I, Haarmann P. Percutaneous transluminal angioplasty of proximal subclavian artery occlusions. Cardiovasc Intervent Radiol. 1993;16(4):214–8.CrossRefPubMed
11.
Millaire A, Trinca M, Marache P, de Groote P, Jabinet JL, Ducloux G. Subclavian angioplasty: immediate and late results in 50 patients. Cathet Cardiovasc Diagn. 1993;29(1):8–17.CrossRefPubMed
12.
Tyagi S, Verma PK, Gambhir DS, Kaul UA, Saha R, Arora R. Early and long-term results of subclavian angioplasty in aortoarteritis (Takayasu disease): comparison with atherosclerosis. Cardiovasc Intervent Radiol. 1998;21(3):219–24.CrossRefPubMed
13.
Bogey WM, Demasi RJ, Tripp MD, Vithalani R, Johnsrude IS, Powell SC. Percutaneous transluminal angioplasty for subclavian artery stenosis. Am Surg. 1994;60(2):103–6.PubMed
14.
Rodriguez-Lopez JA, Werner A, Martinez R, Torruella LJ, Ray LI, Diethrich EB. Stenting for atherosclerotic occlusive disease of the subclavian artery. Ann Vasc Surg. 1999;13(3):254–60.CrossRefPubMed
15.
Hadjipetrou P, Cox S, Piemonte T, Eisenhauer A. Percutaneous revascularization of atherosclerotic obstruction of aortic arch vessels. J Am Coll Cardiol. 1999;33(5):1238–45.CrossRefPubMed
16.
Henry M, Amor M, Henry I, Ethevenot G, Tzvetanov K, Chati Z. Percutaneous transluminal angioplasty of the subclavian arteries. J Endovasc Surg. 1999;6(1):33–41.CrossRefPubMed
17.
Korner M, Baumgartner I, Do DD, Mahler F, Schroth G. PTA of the subclavian and innominate arteries: long-term results. Vasa. 1999;28(2):117–22.CrossRefPubMed
18.
Motarjeme A. Percutaneous transluminal angioplasty of supra-aortic vessels. J Endovasc Surg. 1996;3(2):171–81.CrossRefPubMed
19.
Bali HK, Bhargava M, Jain AK, Sharma BK. De novo stenting of descending thoracic aorta in Takayasu arteritis: intermediate-term follow-up results. J Invasive Cardiol. 2000;12(12):612–7.PubMed
20.
Schillinger M, Haumer M, Schillinger S, Ahmadi R, Minar E. Risk stratification for subclavian artery angioplasty: is there an increased rate of restenosis after stent implantation? J Endovasc Ther. 2001;8(6):550–7.CrossRefPubMed
21.
Moher D, Liberati A, Tetzlaff J, Altman DG. Reprint—preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther. 2009;89(9):873–80.PubMed
22.
23.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.CrossRefPubMed
24.
Chatterjee S, Nerella N, Chakravarty S, Shani J. Angioplasty alone versus angioplasty and stenting for subclavian artery stenosis—a systematic review and meta-analysis. Am J Ther. 2013;20(5):520–3.CrossRefPubMed
25.
Sixt S, Rastan A, Schwarzwalder U, Burgelin K, Noory E, Schwarz T, Beschorner U, Frank U, Muller C, Hauk M, Leppanen O, Hauswald K, Brantner R, Nazary T, Neumann FJ, Zeller T. Results after balloon angioplasty or stenting of atherosclerotic subclavian artery obstruction. Catheter Cardiovasc Interv. 2009;73(3):395–403.CrossRefPubMed
26.
Brountzos ENMK, Kelekis DA, Andreas H, Mahnken, Hülsbeck SM. Cirse Quality Assurance Guidelines For The Endovascular Treatment of Occlusive Lesions of the Subclavian and Innominate Arteries Cardiovascular and Interventional Radiological Society of Europe; 2013.
27.
Palmaz JC, Kopp DT, Hayashi H, Schatz RA, Hunter G, Tio FO, Garcia O, Alvarado R, Rees C, Thomas SC. Normal and stenotic renal arteries: experimental balloon-expandable intraluminal stenting. Radiology. 1987;164(3):705–8.CrossRefPubMed
28.
Shah PK. Inflammation, neointimal hyperplasia, and restenosis: as the leukocytes roll, the arteries thicken. Circulation. 2003;107(17):2175–7.CrossRefPubMed
29.
Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, Vist GE, Falck-Ytter Y, Meerpohl J, Norris S, Guyatt GH. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401–6.CrossRefPubMed
30.
Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso-Coello P, Rind D, Devereaux PJ, Montori VM, Freyschuss B, Vist G, Jaeschke R, Williams JW Jr, Murad MH, Sinclair D, Falck-Ytter Y, Meerpohl J, Whittington C, Thorlund K, Andrews J, Schunemann HJ. GRADE guidelines 6. Rating the quality of evidence–imprecision. J Clin Epidemiol. 2011;64(12):1283–93.CrossRefPubMed
31.
Przewlocki T, Kablak-Ziembicka A, Pieniazek P, Musialek P, Kadzielski A, Zalewski J, Kozanecki A, Tracz W. Determinants of immediate and long-term results of subclavian and innominate artery angioplasty. Catheter Cardiovasc Interv. 2006;67(4):519–26.CrossRefPubMed
32.
Higashimori A, Morioka N, Shiotani S, Fujihara M, Fukuda K, Yokoi Y. Long-term results of primary stenting for subclavian artery disease. Catheter Cardiovasc Interv. 2013;82(5):696–700.CrossRefPubMed
33.
Li Y, Yin Q, Zhu W, Wang Y, Fan X, Liu D, Chen M, Wang Q, Xu G, Yan B, Liu X. Endovascular stenting for atherosclerotic subclavian artery stenosis in patients with other craniocervical artery stenosis. J Thromb Thrombolysis. 2013;35(1):107–14.CrossRefPubMed
34.
Babic S, Sagic D, Radak D, Antonic Z, Otasevic P, Kovacevic V, Tanaskovic S, Ruzicic D, Aleksic N, Vucurevic G. Initial and long-term results of endovascular therapy for chronic total occlusion of the subclavian artery. Cardiovasc Intervent Radiol. 2012;35(2):255–62.CrossRefPubMed
35.
Song L, Zhang J, Li J, Gu Y, Yu H, Chen B, Guo L, Wang Z. Endovascular stenting vs. extrathoracic surgical bypass for symptomatic subclavian steal syndrome. J Endovasc Ther. 2012;19(1):44–51.CrossRefPubMed
36.
Wang KQ, Wang ZG, Yang BZ, Yuan C, Zhang WD, Yuan B, Xing T, Song SH, Li T, Liao CJ, Zhang Y. Long-term results of endovascular therapy for proximal subclavian arterial obstructive lesions. Chin Med J. 2010;123(1):45–50.PubMed
37.
Linni K, Ugurluoglu A, Mader N, Hitzl W, Magometschnigg H, Holzenbein TJ. Endovascular management versus surgery for proximal subclavian artery lesions. Ann Vasc Surg. 2008;22(6):769–75.CrossRefPubMed
38.
Sixt S, Rastan A, Schwarzwalder U, Schwarz T, Norry E, Frank U, Muller C, Beschorner U, Burgelin K, Nazary T, Hauswald K, Hauk M, Neumann FJ, Zeller T. Long term outcome after balloon angioplasty and stenting of subclavian artery obstruction: a single centre experience. Vasa. 2008;37(2):174–82.CrossRefPubMed
39.
Palchik E, Bakken AM, Wolford HY, Saad WE, Davies MG. Subclavian artery revascularization: an outcome analysis based on mode of therapy and presenting symptoms. Ann Vasc Surg. 2008;22(1):70–8.CrossRefPubMed
40.
Van Noord BA, Lin AH, Cavendish JJ. Rates of symptom reoccurrence after endovascular therapy in subclavian artery stenosis and prevalence of subclavian artery stenosis prior to coronary artery bypass grafting. Vasc Health Risk Manag. 2007;3(5):759–62.PubMedPubMedCentral
41.
Filippo F, Francesco M, Francesco R, Corrado A, Chiara M, Valentina C, Giuseppina N, Salvatore N. Percutaneous angioplasty and stenting of left subclavian artery lesions for the treatment of patients with concomitant vertebral and coronary subclavian steal syndrome. Cardiovasc Intervent Radiol. 2006;29(3):348–53.CrossRefPubMed
42.
De Vries JP, Jager LC, Van den Berg JC, Overtoom TT, Ackerstaff RG, Van de Pavoordt ED, Moll FL. Durability of percutaneous transluminal angioplasty for obstructive lesions of proximal subclavian artery: long-term results. J Vasc Surg. 2005;41(1):19–23.CrossRefPubMed
43.
Modarai B, Ali T, Dourado R, Reidy JF, Taylor PR, Burnand KG. Comparison of extra-anatomic bypass grafting with angioplasty for atherosclerotic disease of the supra-aortic trunks. Br J Surg. 2004;91(11):1453–7.CrossRefPubMed
44.
Angle JF, Matsumoto AH, McGraw JK, Spinosa DJ, Hagspiel KD, Leung DA, Tribble CG. Percutaneous angioplasty and stenting of left subclavian artery stenosis in patients with left internal mammary-coronary bypass grafts: clinical experience and long-term follow-up. Vasc Endovascular Surg. 2003;37(2):89–97.CrossRefPubMed
45.
Schillinger M, Haumer M, Schillinger S, Mlekusch W, Ahmadi R, Minar E. Outcome of conservative versus interventional treatment of subclavian artery stenosis. J Endovasc Ther. 2002;9(2):139–46.PubMed
46.
Takach TJ, Reul GJ, Gregoric I, Krajcer Z, Duncan JM, Livesay JJ, Cooley DA. Concomitant subclavian and coronary artery disease. Ann Thorac Surg. 2001;71(1):187–9.CrossRefPubMed
47.
Martinez R, Rodriguez-Lopez J, Torruella L, Ray L, Lopez-Galarza L, Diethrich EB. Stenting for occlusion of the subclavian arteries. Technical aspects and follow-up results. Tex Heart Inst J. 1997;24(1):23–7.PubMedPubMedCentral
48.
Cook AM, Dyet JF. Six cases of subclavian stenosis treated by percutaneous angioplasty. Clin Radiol. 1989;40(4):352–4.CrossRefPubMed
49.
Jaschke W, Menges HW, Ockert D, Huck K, Georgi M. PTA of the subclavian and innominate artery: short- and long-term results. Ann Radiol. 1989;32(1):29–33.PubMed
50.
Burke DR, Gordon RL, Mishkin JD, McLean GK, Meranze SG. Percutaneous transluminal angioplasty of subclavian arteries. Radiology. 1987;164(3):699–704.CrossRefPubMed
51.
Wilms G, Baert A, Dewaele D, Vermylen J, Nevelsteen A, Suy R. Percutaneous transluminal angioplasty of the subclavian artery: early and late results. Cardiovasc Intervent Radiol. 1987;10(3):123–8.CrossRefPubMed
52.
Lowman BG, Queral LA, Holbrook WA, Estes JT, Bayly B, Dagher FJ. The correction of cerebrovascular insufficiency by transluminal dilatation: a preliminary report. Am Surg. 1983;49(11):621–4.PubMed
53.
Miyakoshi A, Hatano T, Tsukahara T, Murakami M, Arai D, Yamaguchi S. Percutaneous transluminal angioplasty for atherosclerotic stenosis of the subclavian or innominate artery: angiographic and clinical outcomes in 36 patients. Neurosurg Rev. 2012;35(1):121–5.CrossRefPubMed
54.
Yu J, Korabathina R, Coppola J, Staniloae C. Transradial approach to subclavian artery stenting. J Invasive Cardiol. 2010;22(5):204–6.PubMed
55.
Sakai C, Sakai N, Kuroiwa T, Ishihara H, Adachi H, Morizane A, Yano T, Kajikawa R, Yamagami H, Kobayashi J, Kondo K, Kikuchi H. Stenting for chronic total occlusion of the proximal subclavian artery. Interv Neuroradiol. 2007;1:135–40.CrossRef
56.
Amor M, Eid-Lidt G, Chati Z, Wilentz JR. Endovascular treatment of the subclavian artery: stent implantation with or without predilatation. Catheter Cardiovasc Interv. 2004;63(3):364–70.CrossRefPubMed
57.
Gonzalez A, Gil-Peralta A, Gonzalez-Marcos JR, Mayol A. Angioplasty and stenting for total symptomatic atherosclerotic occlusion of the subclavian or innominate arteries. Cerebrovasc Dis. 2002;13(2):107–13.CrossRefPubMed
58.
Kumar K, Dorros G, Bates MC, Palmer L, Mathiak L, Dufek C. Primary stent deployment in occlusive subclavian artery disease. Cathet Cardiovasc Diagn. 1995;34(4):281–5.CrossRefPubMed
59.
Perrault LP, Carrier M, Hudon G, Lemarbre L, Hebert Y, Pelletier LC. Transluminal angioplasty of the subclavian artery in patients with internal mammary grafts. Ann Thorac Surg. 1993;56(4):927–30.CrossRefPubMed
60.
Hebrang A, Maskovic J, Tomac B. Percutaneous transluminal angioplasty of the subclavian arteries: long-term results in 52 patients. AJR Am J Roentgenol. 1991;156(5):1091–4.CrossRefPubMed
Metadaten
Titel
Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis
Publikationsdatum
02.12.2015
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 5/2016
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-015-1250-9

Weitere Artikel der Ausgabe 5/2016

CardioVascular and Interventional Radiology 5/2016 Zur Ausgabe

Technical Note

MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility

Clinical Investigation

Evaluation of Aneurysm Neck Angle Change After Endovascular Aneurysm Repair Clinical Investigations

Case Report

Percutaneous Puncture of the Superior Vena Cava with Insertion of a Cuff Catheter to Address Multiple-Site Venous Occlusion in Hemodialysis Patients

Letter to the Editor

Pediatric Gastroduodenal Embolization with a Microvascular Plug

Clinical Investigation

Correlation of Peripheral Vein Tumour Marker Levels, Internal Iliac Vein Tumour Marker Levels and Radical Prostatectomy Specimens in Patients with Prostate Cancer and Borderline High Prostate-Specific Antigen: A Pilot Study

Clinical Investigation

Intra-vesical Prostatic Protrusion (IPP) Can Be Reduced by Prostatic Artery Embolization

Neu im Fachgebiet Radiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise