Endovascular management versus open surgery for subclavian steal syndrome

Abstract

Objective To evaluate the therapeutic effects and safety of open surgery vs. endovascular procedures for subclavian steal syndrome (SSS). Methods A retrospective analysis was made on 112 patients from July 2005 to July 2014 including 72 undergoing endovascular therapy and 40 cases treated by open bypass surgery. Results There were not difference between endovascular therapy group and surgical group in technical success rate (95.8% vs. 100%, P=0.239), postoperative subclavian artery diameter [(8.3±1.6) mm vs. (8.1±0.7) mm, P=0.374], postoperative suffering/contralateral systolic pressure ratio [(0.95±0.12) vs. (0.96±0.15), P=0.518]. Nor there were the differences in mortality [0(0%) vs. 3 (7.5%), P=0.018], postoperative renal dysfunction [2 (2.8%) vs. 5 (12.5%), P=0.042], wound infections [1 (1.4%) vs. 4 (10%), P=0.034], duration of operation [(1.5±0.32) h vs. (2.7±0.51) h, P=0.027], days in hospital [(5.7±3) d vs. (9.3±3) d, P=0.013]. After 1, 3, 5 years postoperative follow-up the two groups were not significantly different in patency rates, subclavian artery diameter, suffering/contralateral systolic pressure ratio (all P>0.05). Conclusion For subclavian artery steal syndrome, endovascular treatment is safe, effective and minimally invasive. Key words: Subclavian steal syndrome; Angioplasty; Stents