TY - JOUR
T1 - Balloon angioplasty above the aortic arch
T2 - Immediate and long-term results
AU - Selby, J. B.
AU - Matsumoto, A. H.
AU - Tegtmeyer, C. J.
AU - Hartwell, G. D.
AU - Tribble, C. G.
AU - Daniel, T. M.
AU - Kron, I. L.
PY - 1993
Y1 - 1993
N2 - OBJECTIVE. Angioplasty above the level of the aortic arch is becoming more common, and the indications for it are increasing. We report our experience with this procedure, including life-table analysis of the long-term results. MATERIALS AND METHODS. We dilated 32 lesions in 29 patients. Early in our series, patients were referred primarily because of arm claudication or vertebrobasilar insufficiency. Subsequently, the indications were expanded to include inflow to left internal mammary-coronary artery bypass grafts, inflow to axillobifemoral bypass grafts, and inflow to dialysis fistulas in the upper extremity. A femoral artery approach was used in 18 patients and an axillary approach was used in 11. Clinical follow-up included evaluation of symptoms and bilateral measurements of peripheral pulses and blood pressure. Follow-up angiograms were obtained in nine patients. RESULTS. Eighteen of the lesions dilated were located in the left subclavian artery, eight were in the right subclavian artery, four were in the axillary or proximal brachial artery, and two were in the innominate artery. Interestingly, three of eight right subclavian arteries treated had an anomalous origin from the arch of the aorta. Initial technical success was 100%. All 29 patients had long-term follow-up of 4-88 months (mean, 36 months). In one patient, stenosis recurred 8 months after angioplasty. This patient subsequently had redilatation. Life- table analysis projected a 7.5-year cumulative primary patency rate of 96.6%. No cerebrovascular complications or embolic events occurred. CONCLUSION. Angioplasty of the great vessels is safe and effective, and the long-term results are favorable when compared with results after surgery. As a result, the indications for this procedure should be broadened.
AB - OBJECTIVE. Angioplasty above the level of the aortic arch is becoming more common, and the indications for it are increasing. We report our experience with this procedure, including life-table analysis of the long-term results. MATERIALS AND METHODS. We dilated 32 lesions in 29 patients. Early in our series, patients were referred primarily because of arm claudication or vertebrobasilar insufficiency. Subsequently, the indications were expanded to include inflow to left internal mammary-coronary artery bypass grafts, inflow to axillobifemoral bypass grafts, and inflow to dialysis fistulas in the upper extremity. A femoral artery approach was used in 18 patients and an axillary approach was used in 11. Clinical follow-up included evaluation of symptoms and bilateral measurements of peripheral pulses and blood pressure. Follow-up angiograms were obtained in nine patients. RESULTS. Eighteen of the lesions dilated were located in the left subclavian artery, eight were in the right subclavian artery, four were in the axillary or proximal brachial artery, and two were in the innominate artery. Interestingly, three of eight right subclavian arteries treated had an anomalous origin from the arch of the aorta. Initial technical success was 100%. All 29 patients had long-term follow-up of 4-88 months (mean, 36 months). In one patient, stenosis recurred 8 months after angioplasty. This patient subsequently had redilatation. Life- table analysis projected a 7.5-year cumulative primary patency rate of 96.6%. No cerebrovascular complications or embolic events occurred. CONCLUSION. Angioplasty of the great vessels is safe and effective, and the long-term results are favorable when compared with results after surgery. As a result, the indications for this procedure should be broadened.
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U2 - 10.2214/ajr.160.3.8430569
DO - 10.2214/ajr.160.3.8430569
M3 - Article
C2 - 8430569
AN - SCOPUS:0027397086
SN - 0361-803X
VL - 160
SP - 631
EP - 635
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 3
ER -