A COMPARATIVE STUDY OF THE LONG-TERM RESULTS OF OPEN OPERATIONS AND ENDOVASCULAR INTERVENTIONS FOR ATHEROSCLEROTIC STENOSES OF THE BRACHIOCEPHALIC TRUNK

A.V. Pokrovsky, D.F. Beloyartsev
Department of Vascular Surgery, A.V. Vishnevsky Institute of Surgery,
Russian Academy of Medical Sciences,
Moscow, Russia

Objectives: our aim was to carry out a retrospective comparison of the long-term results of open and endovascular interventions for atherosclerotic stenoses of the brachiocephalic trunk (BCT).

Materials and methods: forty-five patients with BCT stenoses underwent 18 consecutive intrathoracic reconstructions and 27 balloon angioplasties. The long-term results of open interventions were followed up for a mean of 70±17 months (up to 169 months maximally). The long-term results of balloon angioplasties were followed up for a mean of 68±8 months (up to 117 months maximally). In a subgroup of patients who underwent intrathoracic operations, we studied the destiny of 12 (71%) of the 17 patients whereas in a subgroup provided dilatations, we examined the destiny of 18 (75%) of the 24 patients.

Results: graft patency was preserved in 92% of patients, that of the dilated arteries in 94%. The clinical effect of surgery in the subgroups provided open reconstructions and endovascular interventions persisted in 83% and 89% of patients respectively, the incidence of strokes in the long-term period was 8% and 6%, the lethality reached 25% and 17%.

Conclusions: endovascular intervention is the method of choice in the treatment for atherosclerotic lesions of the BCT without injury to its bifurcation.

KEY WORDS: atherosclerosis, brachiocephalic trunk, intrathoracic reconstructions, balloon angioplasty, long-term results.

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