Clinical Research Of Endovascular Treatment Of Subclavian Steal Syndrome

Objective:To compare the therapeutic effects and security of traditional surgery and endovascular therapy for subclavian steal syndrome(SSS).Methods:From July2005to January2013, the data of112patients with SSS treated in our hospital were analyzed.72cases received endovascular treatment,as the experimental group;40cases received conventional artery bypass surgery, as a control group.We retrospectively reviewed112cases, includes:1, preoperative clinical data:age, sex,history of hypertension,a history of coronary heart disease,diabetes mellitus, smoking history, ipsilateral/contralateral brachial systolic blood pressure ratio.2, intraoperative and postoperative clinical data:operative time,hospital stay, ipsilateral/contralateral brachial systolic blood pressure ratio,perioperative complications(such as renal insufficiency,death).3,the follow-up data.Results:The two groups were compared before surgery:gender (male/female chamber groups:43/29,the bypass group:24/16),age(endovascular group:67.3years,the bypass group:65.8years),hypertension history(endovascular group:28cases,the bypass group:17cases),coronary heart disease(endovascular group:15cases,the bypass group:8cases),diabetes mellitus(endovascular group:21cases,the bypass, group:13cases), dyslipidemia(endovascular group:47cases,the bypass group:28cases),smoking history(endovascular group:57cases,the bypass group:32cases), ipsilateral/contralateral systolic pressure ratio(endovascular group:0.60±0.11, bypass group:0.57±0.12),SA diameter(endovascular group:2.1±1.1mm,the bypass group:2.3±0.9mm),P>0.05.There were no statistically significant differences.After comparing the two groups of patients:In ipsilateral/contralateral systolic pressure ratio, the endovascular group:0.95±0.12, the bypass group:0.96±0.15, P>0.05,no statistically significant difference. But endovascular intervention group and traditional surgical bypass surgery group in operative time (endovascular group:1.5±0.32, bypass group:2.7±0.51)and hospital stay (endovascular group:5.7±3, the bypass group:9.3±3), there were statistically significant differences. Especially comparing the perioperative complications, deaths, endovascular group0cases(0%), the bypass group3patients (7.5%),P<0.05;postoperative renal dysfunction, endovascular group:two cases (2.8%),the bypass group:5cases(12.5%),P<0.05;aspects of wound infection, endovascular group:1case(1.4%),the bypass group:4cases(10%), P＜0.05.Description chamber groups in terms of perioperative complications was significantly better than the bypass group.Patients were followed up6-60months,between endovascular treatment with conventional surgery,recent mid-term patency rate was no significant difference.Conclusions:SSS endovascular intervention compared with traditional surgery,no significant difference in the treatment effect,recent mid-term patency rates.Endovascular interventional treatment of perioperative complications,operative time and hospital stay was significantly less than traditional artery bypass surgery.Meanwhile,with minimally invasive endovascular intervention characteristics,to avoid the risk of general anesthesia, postoperative physical conducive to recovery,providing access to treatment for those with poor physical condition of the body SSS patients.