Mid-Term Results of Surgical Treatment of Coronary-Subclavian Steal Syndrome

Objective: The aim of this study is to evaluate the mid-term results of subclavian artery revascularization in coronary subclavian steal syndrome. Material and Methods: A total of 9 patients with the diagnosis of coronary subclavian steal syndrome were reviewed retrospectively. All patients underwent extra-anatomic bypass operation for subclavian artery revascularization. Angiography or computed tomography angiography was performed to evaluate subclavian artery stenosis, coronary steal and graft patency, before and after the operations. Results: Between 2006 and 2013, 9 consecutive patients (6 males, 3 females; average age: 58.6 years; age range: 44 to 67 years) were included in the study. All patients had stable angina. The mean time elapsed between the coronary artery bypass graft surgery and the onset of patient"s complaints due to the coronary subclavian steal syndrome was 5.45 years (range: 3-12 years). Carotidsubclavian bypass was performed in 6 patients, and subclavian-subclavian bypass was performed in 3 patients. One patient who underwent carotid-subclavian bypass died due to myocardial infarction. Stroke was not seen in any of the patients. The average follow-up period was 45.3±28 months (range: 5-92 months). Graft occlusion was detected in 3 patients at 4th, 22nd (subclaviansubclavian bypass) and 34th (carotid-subclavian bypass) months. There were no late deaths. Conclusion: Extra-anatomic procedures may provide an effective treatment for coronary subclavian steal syndrome.