ABSTRACT
Severe subclavian artery lesion is an important medical and social problem worsening the quality of life and leading to dire consequences. Vertebrobasilar insufficiency is the main syndrome of lesion of the first segment of subclavian artery. About 20% of all ischemic strokes occur in vertebrobasilar basin. At present, surgical treatment of asymptomatic patients with severe lesion of the 1st segment of subclavian artery is still debatable. Open surgery is optimal for occlusion of this vascular segment. Carotid-subclavian transposition is a preferable option with favorable in-hospital and long-term results. However, carotid-subclavian bypass is an equivalent alternative in case of difficult transposition following anatomical and topographic features of vascular architectonics. Endovascular treatment is preferable for isolated subclavian artery stenosis and should certainly include stenting.
Subject(s)
Atherosclerosis , Subclavian Steal Syndrome , Vertebrobasilar Insufficiency , Humans , Subclavian Artery/diagnostic imaging , Subclavian Artery/surgery , Quality of Life , Subclavian Steal Syndrome/diagnosis , Subclavian Steal Syndrome/etiology , Subclavian Steal Syndrome/surgery , Atherosclerosis/complications , Atherosclerosis/diagnosis , Atherosclerosis/surgery , Vertebrobasilar Insufficiency/diagnosis , Vertebrobasilar Insufficiency/etiology , Vertebrobasilar Insufficiency/surgery , Stents , Treatment OutcomeABSTRACT
Presented in the article is a review of the literature related to comparing the outcomes of carotid endarterectomy and carotid stenting in treatment of atherosclerotic stenosis of the internal carotid artery. Special attention is paid to carefully considering the clinical situations wherein preference should be given to either method of intervention.
Subject(s)
Blood Vessel Prosthesis Implantation , Carotid Stenosis/surgery , Endarterectomy, Carotid , Graft Occlusion, Vascular , Postoperative Complications , Stents , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/methods , Carotid Artery, Internal/pathology , Carotid Artery, Internal/surgery , Comparative Effectiveness Research , Endarterectomy, Carotid/adverse effects , Endarterectomy, Carotid/methods , Graft Occlusion, Vascular/diagnosis , Graft Occlusion, Vascular/epidemiology , Graft Occlusion, Vascular/etiology , Humans , Outcome Assessment, Health Care , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Risk Factors , Vascular PatencyABSTRACT
Authors present a literature review on the prevalence, clinical presentations, diagnosis and outcome of surgical treatment of atherosclerotic stenosis of the internal carotid artery.
