Artery bypass surgery and endovascular treatment for subclavian arterial sclerosis occlusion disease / 中华普通外科杂志

ABSTRACT

Objective To investigate the safety and medium-and long-term effects of endovascular stenting,axilloaxillary bypass (AAB),carotid-subclavian bypass (CSB) in patients of subclavian arterial occlusion.Method From 2001 to 2013,311 consecutive patients with subclavian arteriosclerosis obliterans were treated with endovascular stenting (n =191),axilloaxillary bypass (n =96) or carotidsubclavian bypass(n =32).We collected patients' medical data,calculated patency of the graft or stent with life-table method and compared patency between three approaches with Log-rank.Results The incidence of perioperative complications was 4.1％ in the stenting group vs.11.5％ in AAB group vs.18.7％ in CSB group.There was significant statistical differences between the stenting group and bypass group about the incidence of perioperative complications.The primary patency rates at 1,3 and 5 years were 90.3％,84％,81.6％ in stenting group vs.95.3％,92.6％,88.9％ for AAB group vs.100％,96.4％,96.4％ for CSB group.There was significant statistical differences between the stenting group and bypass group about the primary patency rates.Conclusions Both endovascular stenting and extrathoracic surgical bypass are safe and effective treatments for subclavian arteriosclerosis obliterans.However,effect of extrathoracic surgical bypass is more durable in the medium-and long-term.