Baylor University Medical Center Proceedings October 2017 - 432
and showed multifocal obstructive atherosclerotic lesions of the
axillary arteries bilaterally. Serologic studies had been negative
for an underlying inflammatory and/or autoimmune process
with the exception of a mildly elevated erythrocyte sedimentation rate. The patient underwent upper-extremity angiography, confirming the sonographic and CT angiography findings
(Figure 1a). Given optimal medical therapy and refractory right
arm claudication, the patient opted for endovascular therapy.
A 6Fr 90 cm Cook sheath was advanced via the left common femoral artery into the right brachiocephalic trunk for
endovascular intervention using standard sheath delivery techniques. Unfractionated heparin with a goal partial thromboplastin time of 250 to 300 seconds was given. The lesions in
the axillary artery were crossed using a 0.018˝ gold-tip Glidewire
(Terumo Medical Corp., Somerset, NJ). The 0.018˝ glidewire
was exchanged for a supportive 0.035˝ SupraCore wire (Abbott,
Table 1. Summary of published data on patency rates of upper-extremity revascularization
First author (Ref)
Year
Number of patients/
narrowings
Follow-up
in months
Lowman (11)
1983
10/10
13
Subclavian and innominate
PTA
90%
Wilms (12)
1987
22/23
25
Subclavian
PTA
82%
Burke (13)
1987
27/30
36
Subclavian, innominate, and vertebral
PTA
NA
Cook (14)
1989
6/6
18
Subclavian
PTA
83%
Jaschke (15)
1989
12/12
12
Subclavian, innominate, and axillary
PTA
91%
Qi (16)
1991
125/125
46
Subclavian and vertebral
PTA
99%
Hebrang (17)
1991
52/52
29
Subclavian
PTA
91%
Perrault (18)
1993
11/11
38
Subclavian
PTA
100%
Millaire (19)
1993
50/50
41
Subclavian
PTA
86%
Kumar (20)
1995
27/31
NA
Subclavian
Stent
NA
Motarjeme (21)
1996
112/151
60
Innominate, subclavian, carotid, and vertebral
PTA
97%
Martinez (22)
1997
17/17
19.4
Subclavian
Stent
81%
Rodriguez-Lopez (9)
1999
69/70
13
Subclavian
Stent
73%
Körner (23)
1999
37/43
15
Subclavian and innominate
PTA
72%
Schillinger (24)
2001
115/115
44
Subclavian
PTA ± stent
59%
González (25)
2002
9/9
37.4
Subclavian
PTA
89%
Angle (26)
2003
21/21
27
Subclavian
PTA ± stent
79%
Modarai (3)
2004
41/41
48
Subclavian and innominate
PTA ± stent
82%
Amor (27)
2004
86/89
42
Subclavian
Stent
81%
De Vries (5)
2005
110/110
34
Subclavian
PTA ± stent
88%
Filippo (28)
2006
42/42
60
Subclavian
Stent
71%
Przewlocki (29)
2006
75/76
24.4
Subclavian and innominate
PTA ± stent
77%
Sakai (30)
2007
26/28
6
Subclavian
Stent
100%
Abu Rahma (31)
2007
121/121
41
Subclavian
PTA ± stent
70%
Subclavian and brachiocephalic
PTA ± stent
76%
Subclavian
Stent
95%
Narrowest artery
Revascularization
Patency
Van Noord (32)
2007
43/43
12
Linni (33)
2008
40/40
50.1
Sixt (4)
2009
107/108
12
Subclavian and brachiocephalic
PTA ± stent
88%
Yu (34)
2010
14/14
12
Subclavian
Stent
93%
Wang (35)
2010
59/61
40.7
Subclavian
Stent
85%
Song (36)
2012
148/148
67
Subclavian
Stent
49%
Babic (37)
2012
56/56
40
Subclavian
Stent
83%
Li (38)
2013
71/71
27
Subclavian
Stent
85%
Higashimori (39)
2013
59/60
49
Subclavian
Stent
86%
Almeida (40)
2014
16/16
12
Subclavian
Stent
100%
Che (41)
2016
167/167
60.6
Subclavian
Stent
87%
NA indicates not available; PTA, percutaneous transluminal angioplasty.
432
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