Treatment of atherosclerotic lesion of the first segment of subclavian artery

Beloyartsev D.F.; Adyrkhaev Z.A.; Fagamov R.R.

doi:https://doi.org/10.17116/hirurgia202312195

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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 1^st 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.

Keywords:

subclavian artery

vertebrobasilar insufficiency

carotid-subclavian transposition

carotid-subclavian bypass

transluminal balloon angioplasty

subclavian artery stenting

Authors:

Beloyartsev D.F.

Vishnevsky National Medical Research Center of Surgery;
Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0002-7808-3454

Adyrkhaev Z.A.

Vishnevsky National Medical Research Center of Surgery;
Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0001-6013-4017

Fagamov R.R.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0002-3149-7190

Received:

07.04.2023

Accepted:

04.09.2023

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References:

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