Left subclavian artery stenting: an option for the treatment of the coronary-subclavian steal syndrome

• Main Authors: Bruno Lorenção de Almeida, Antonio Massamitsu Kambara, Fabio Henrique Rossi, Samuel Martins Moreira, Eduardo Silva Jordao de Oliveira, Frederico Augusto de Carvalho Linhares Filho, Patrick Bastos Metzger, Aldo Zampieri Passalacqua
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cirurgia Cardiovascular 2014-04-01
• Series: Brazilian Journal of Cardiovascular Surgery
• Subjects: Angioplastia; Doença Arterial Periférica; Doença das Coronárias; Artéria Subclávia; Síndrome do Roubo Coronário-Subclávio
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000200236&lng=en&tlng=en

Introduction: The subclavian steal syndrome is characterized by the vertebral artery flow inversion, due to a stenotic lesion in the origin of the subclavian artery. The Coronary-subclavian Steal Syndrome is a variation of the Subclavian Steal Syndrome and is characterized by inversion of flow in the Internal Thracic artery that has been used as conduct in a myocardial revascularization. Its diagnosis must be suspected in patients with difference in pulse and arterial pressure in the upper limbs, that present with angina pectoris and that have done a myocardial revascularization. Its treatment must be a surgical bypass or a transluminal angioplasty. Objective: The objective is to show the left subclavian artery stenting as a safe and effective method to treat the coronary-subclavian steal syndrome. Methods: Historical prospective, non-randomized trial, through revision of the hospital records of the patients treated with the stenting of the left subclavian artery, from January 2006 to September 2012. Results: In the mentioned period, 4.291 miocardial revascularizations were performed with the use of the left mammary artery, and 16 patients were identified to have the Coronary-subclavian steal syndrome. All of them were submitted to endovascular treatment. The success rate was 100%; two patients experienced minor complications; none of them presented with major complications. Eleven of the 16 patients had ultrassonographic documentation of patent stent for at least one year; two patients lost follow up and other two died. Conclusion: The stenting of the left subclavian artery is a good option for the treatment of the Coronary-subclavian Steal Syndrome, with high level of technical and clinical success.