To Choose Optimality Methods (Carotid Subclavian Bypass or Stenting of Subclavian) of Treatment Group of Patients with Occluded-Stenosed First Segment of a.Subclavian

Alexander V. Gavrilenko, Gyurikhan Magomedova, Vladimir A. Ivanov, Andrey V. Kuklin, Nadeem N. Al-Yousef

Petrovsky National Research Center of Surgery , Moscow, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – B

Abstract

Aim : to find optimality methods(carotid subclavian bypass or stenting of subclavian ) of treatment group of patients with occlusal-stenosed first segment of a.subclavian.

M/M :

This investigation include 150 patients with defeat first segment of a.subclavian. We devide these patients on two groups. First group include 75 patients , which was performed carotid subclavian bypass. An occlusion of a.sucblavian were in 39 cases(52 %) (P>0.05).A permanent subclavian steal syndrome in 54 cases (P>0.05). Accompayning cardiac pathology was observed in 41 (55%) cases (2 cases after stroke).Second group 75 patients which were perfomed endovascular intervention The occlusion of artery subclavian were in 72 (43%) cases,the permanent steal syndrome were in 49 cases. The accompanying cardiac pathology in 38 (51%) (11 patients (15%)after stoke) (P>0.05).

Results:

In first group were three complications (2 cases of paralysis of the diaphragmatic nerve,atelectasis-1) in postoperative period. In second group were 3 complications too (distal embolism -1,false aneurysm-2).

In 6 months after operation ; in first group of 49 patients was detected thrombosis of the bypass , these patients in anamnesis had atrial fibrillation. In second group of 72 patients the bypass stopped function in 12 cases and a.subclavian was occlusion in 11 cases.

After 2 years; in first group of 49 patients the bypass functioned in 40 cases.In second group the thrombosis was noticed in 23 cases, previously 20 of these patients had occlusion a.subclavia.

After 5 years; in first group 26 patients the bypass was occlusion in 8 cases. In second group of 27 patients the bypass functioned in 14 cases

In cases with occlusion a.subclavian are required to prefer reconstructive operation.But if the patients have some accompanying cardiac pathology (stroke in anamnesis and others) the right way is prefer endovascular treatment.