Percutaneous Endovascular Approach to Symptomatic High-Grade Subclavian Artery Stenosis: A Retrospective Analysis

Abstract Subclavian artery stenosis (SAS) commonly causes upper limb ischemia and cerebrovascular insufficiency. Percutaneous transluminal angioplasty (PTA) and stenting have emerged as the preferred minimally invasive alternatives to surgical revascularization. This study aimed to evaluate the safety, efficacy, and midterm outcomes of antegrade and retrograde endovascular approaches for symptomatic SAS. This retrospective single-center analysis included 75 patients (45 men and 30 women; mean age, 65.3 years) treated between 2015 and 2023. The average follow-up period was 33.6 months (range, 20–52). The clinical characteristics, procedural techniques, and outcomes were retrospectively reviewed and analyzed. Technical success was achieved in all 75 patients, with no major complications. All patients showed clinical improvement through the resolution of ischemic symptoms and normalized interarm blood pressure differentials. These outcomes match those of prior reports of endovascular procedures, achieving nearly 100% success. During follow-up, 14 patients (18.7%) developed restenosis of the treated segment, which was confirmed by ultrasonography or angiography. Each case was successfully treated with repeated PTA to restore vessel patency. Percutaneous antegrade and retrograde endovascular approaches are safe and effective, providing durable midterm outcomes and representing preferred treatment options over open surgery for symptomatic SAS.