Endovascular treatment of occlusive lesions of the subclavian and innominate arteries

Occlusive lesions of the innominate artery and the subclavian artery might cause serious morbidity and should be treated if symptomatic. Symptoms include neurologic symptoms from the anterior or the posterior circulation and/or upper limb ischemia. An additional indication is the maintenance of inflow for other vascular bypass procedures. Serious vascular comorbidity is usual in patients with innominate artery and subclavian artery atherosclerotic disease. Endovascular treatment is recommended because it has a lower complication rate compared with surgical methods. Although balloon angioplasty might be sufficient, stenting is most frequently used, although there is no level-1 evidence to support the use of stents over angioplasty. Excellent technical and clinical results are obtained with minimal morbidity and mortality. Although long-term patency rates might be inferior to those of surgical procedures, the minimally invasive endovascular treatment is the first choice of treatment for innominate artery and subclavian artery occlusive disease. © Springer Science+Business Media, Inc. 2006.