[Open operations or endovascular interventions in lesions of the first segment of the subclavian artery?].

MATERIAL AND METHODS: The study included a total of 110 patients presenting with stenoses of the first portion of the subclavian artery (SCA). Group One comprised 55 (50%) patients subjected to carotid-subclavian bypass grafting. The degree of stenosis varied from 65 to 95% (p>0.05), occlusion of the SCA was found in 28 (p<0.05) patients, permanent steal syndrome was observed in 39 (p>0.05) patients. Concomitant cardiac pathology was observed in 30 (55%) patients, with one (2%) patient having a history of stroke. Group Two was composed of 55 (50%) patients undergoing endovascular interventions. The degree of stenosis varied from 65 to 95%, with eight patients having occlusion of the SCA. Permanent steal syndrome was observed in 36 patients. Accompanying cardiac pathology was noted in 28 (51%) patients, with eight (15%) patients having a history of stroke (p<0.05).

RESULTS: In Group One, six months after surgery, of 41 cases thrombosis was revealed in 2 patients. 2 years later, of 36 cases, thrombosis was detected in 7 patients. After 5 years, of 19 cases, thrombosis was revealed in 6. After more than 5 years, of 11 cases thrombosis was revealed in 6. In Group Two 6 months after surgery, of 46 cases, the stent ceased to function in 8 patients. After 2 years, of 41 cases, 21 were found to have developed thrombosis. After 5 years - of 20 cases, thrombosis was revealed in 16. Of 7 cases after more than 5 years the stent failed to function in 6.

CONCLUSION: The operation of carotid-subclavian bypass grafting turned out more effective in the remote postoperative period.