Abstract
Percutaneous transluminal angioplasty and stenting for innominate artery pre-occlusive stenosis with subclavian steal syndrome – case report and current challenges
Highlights
Atherosclerotic occlusive disease of the innominate artery (IA) represents a rare entity, comprising less than 2% of all extracranial causes of altered cerebral blood flow
At 9-months follow-up the patient was free of symptoms, no difference in blood pressure between arms was noted and there were no indirect signs of intra-stent stenosis on duplex sonography (Fig. 4)
The 2017 ESVS Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease does not recommend revascularization in asymptomatic patients and most proximal common carotid artery (CCA) and IA stenoses should be considered for treatment via open retrograde angioplasty and stenting (IIa) [4]
Summary
Atherosclerotic occlusive disease of the innominate artery (IA) represents a rare entity, comprising less than 2% of all extracranial causes of altered cerebral blood flow [1]. Patient was discharged 5 days after the intervention, asymptomatic, with equal blood pressure between arms, anterograde flow through the right VA and normal velocities of the right CCA. He received double antiplatelet therapy and statin throughout his admission, and it was recommended to continue this treatment until the evaluation. At 9-months follow-up the patient was free of symptoms, no difference in blood pressure between arms was noted and there were no indirect signs of intra-stent stenosis on duplex sonography (Fig. 4)
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