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Endovascular Treatment of Symptomatic Stenosis of the Brachiocephalic Trunk

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Juszkat R., Pukacki F., Wachal K., Oszkinis G., Staniszewski R., Zieliński M., Majewski W.
Polish Journal of Surgery
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2007
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vol. 79
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issue 1
12-18
EN
The aim of the study was to present our own endovascular treatment results in cases of patients suffering from symptomatic stenosis of the brachiocephalic trunk.Material and methods. During the period between March 2000 and October 2004, 14 patients underwent angioplasty accompanied by stent implantation. The above-mentioned procedure was performed, due to critical, symptomatic stenosis of the brachiocephalic trunk. The patients were diagnosed and placed into different procedural groups based on the physical examination and radiological imaging examinations (Doppler ultrasound and DSA). The immediate and long-term results were evaluated with the physical examination and Doppler ultrasound examination performed at 3-, 6- and 12-months after the procedure.Results. In every patient, the immediate results were positive. Intraoperative DSA angiography confirmed that the artery was dilated. Preoperative clinical symptoms of cerebral and collateral circulation insufficiency in the upper extremity were limited (5/14) or totally regressed (9/14) during the postoperative period. During the intra- and postoperative period, none of the following complications were found: upper extremity arterial embolism, acute arterial thrombosis, dissection or rupture of the brachiocephalic trunk wall, or death. Patients were discharged 2 or 3 days following the procedure. Follow-up examinations confirmed proper blood flow in the brachiocephalic trunk and increased flow in the right vertebral artery. No symptoms of restenosis were found in the area of stent implantation and the stent was not dislocated.Conclusions. Angioplasty accompanied by stent implantation is a safe and efficient treatment method in the case of patients suffering from symptomatic stenosis of the brachiocephalic trunk, particularly in patients with significant operative risk. The hypothesis was confirmed by both perioperative observations and immediate, as well as, long-term patency results.
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