Endovascular interventions for stenoses and occlusions of the brachiocephalic trunk

Karpenko A.A., Starodubtsev V.B., Ignatenko P.V., Saaya Sh.B., Rabtsun A.A.

Siberian Federal Biomedical Research Centre named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia

The study was undertaken to evaluate the efficacy and safety of endovascular interventions in the treatment of stenoses and occlusions of the brachiocephalic trunk (BCT).

Described in the article are the results of retrospectively analysing the efficacy of endovascular interventions performed in a total of forty-five patients presenting with lesions of the BCT. Depending on the type of the BCT lesion, the patients were divided into 2 groups: Group One consisted of 28 patients diagnosed with stenoses of the BCT and Group Two included 17 patients found to have occlusions of the BCT. The outcomes of the interventions were assessed with due regard for the findings obtained by angiography, ultrasonographic duplex scanning of the brachiocephalic vessels, as well as by the examination of the patient’s neurological status. The remote results were evaluated at follow-up terms ranging from 6 months to 4 years.

No ischaemic strokes, myocardial infarctions, nor lethal outcomes were observed during 30 days after the intervention. In the early postoperative period, there occurred 1 (3.6%) case of transitory ischaemic attack in Group One, with also 1 (5.9%) case thereof encountered in Group Two.

Within the time frame of the follow-up period (48 months), recurrent occlusion of the stented segment of the BCT was registered in 2 (7.1%) patients from Group One and in 1 (5.8%) patient from Group Two (p=0.87). The primary patency rate at 4 years in Group One and Group Two patients amounted to 86.8 and 88.3%, respectively (p=0.84).

A conclusion thus drawn was as follows: endovascular intervention for stenoses and occlusions of the BCT is an effective and safe method of preventing acute cerebral circulation impairments in the vertebrobasilar basin.

KEY WORDS: occlusion of the brachiocephalic trunk, endovascular intervention, stenting, vertebrobasilar insufficiency, steal syndrome.

P. 58

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