Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries
Jump to navigation
Jump to search
|
Carotid artery stenosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
ACC/AHA Guideline Recommendations |
|
Periprocedural Management of Patients Undergoing Carotid Endarterectomy |
|
Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease |
|
Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
|
Case Studies |
|
Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries On the Web |
|
American Roentgen Ray Society Images of Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
|
FDA on Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
|
CDC on Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries
2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS: Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)[1]
Management of Patients With Occlusive Disease of the Subclavian and Brachiocephalic Arteries (DO NOT EDIT)[1]
| Class III (No Benefit) |
| "1. Asymptomatic patients with asymmetrical upper-limb blood pressure, periclavicular bruit, or flow reversal in a vertebral artery caused by subclavian artery stenosis should not undergo revascularization unless the internal mammary artery is required for myocardial revascularization. (Level of Evidence: C) " |
| Class IIa |
| "1. Extra-anatomic carotid-subclavian bypass is reasonable for patients with symptomatic posterior cerebral or cerebellar ischemia caused by subclavian artery stenosis or occlusion (subclavian steal syndrome) in the absence of clinical factors predisposing to surgical morbidity or mortality. (Level of Evidence: B) " |
| "2. Percutaneous endovascular angioplasty and stenting is reasonable for patients with symptomatic posterior cerebral or cerebellar ischemia caused by subclavian artery stenosis (subclavian steal syndrome) who are at high risk of surgical complications. (Level of Evidence: C) " |
| "3. Revascularization by percutaneous angioplasty and stenting, direct arterial reconstruction, or extraanatomic bypass surgery is reasonable for patients with symptomatic ischemia involving the anterior cerebral circulation caused by common carotid or brachiocephalic artery occlusive disease. (Level of Evidence: C) " |
| "4. Revascularization by percutaneous angioplasty and stenting, direct arterial reconstruction, or extraanatomic bypass surgery is reasonable for patients with symptomatic ischemia involving upper-extremity claudication caused by subclavian or brachiocephalic arterial occlusive disease. (Level of Evidence: C) " |
| "5. Revascularization by either extra-anatomic bypass surgery or subclavian angioplasty and stenting is reasonable for asymptomatic patients with subclavian artery stenosis when the ipsilateral internal mammary artery is required as a conduit for myocardial revascularization. (Level of Evidence: C) " |
References
- ↑ 1.0 1.1 Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL; et al. (2011). "2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery". Circulation. 124 (4): 489–532. doi:10.1161/CIR.0b013e31820d8d78. PMID 21282505.