Comparative evaluation of the results of carotid-subclavian bypass and endovascular therapy for lesions in the first segment of the subclavian artery

Materials and мethods. The study included 110 patients with the first segment of the subclavian artery stenosis. The first group consisted of 55 (50%) patients who underwent carotid-subclavian bypass. The degree of stenosis ranged from 65 to 95% (p>0.05), 28 patients with subclavian artery occlusion (p<0.05), 39 patients with permanent steal syndrome (p>0.05), 30 (55%) patients with concomitant cardiac pathology, 1 (2%) patient with a history of stroke. The second group included 55 (50%) patients who underwent endovascular intervention. The degree of stenosis ranged from 65 to 95%, 8 patients with subclavian artery occlusion, 36 patients with permanent steal syn- drome, 28 (51%) patients with concomitant cardiac pathology, 8 (15%) patients with a history of stroke (p<0.05).

Results. In the first group shunt thrombosis was detected in 2 patients out of 41 observations 6 months after the surgery. After 2 years shunt thrombosis was detected in 7 patients out of 36 observations. After 5 years shunt thrombosis was detected in 6 patients out of 19 observations. In more than 5 years shunt thrombosis was detected in 6 patients out of 11 observations. In the second group stent ceased to function in 8 patients out of 46 observations 6 months after the surgery. After 2 years thrombosis was detected in 21 patients out of 41 observations. After 5 years thrombosis was detected in 16 patients out of 20 observations. In more than 5 years stent ceased to function in 6 patients out of 7 observations.

Conclusion. In the late postoperative period carotid- subclavian bypass has proved to be more effective.