Angioplasty of the innominate artery in 89 patients: Experience over 19 years

To assess retrospectively the success of percutaneous transluminal angioplasty (PTA) in treating innominate artery stenoses and occlusions in a large series of patients with long-term follow-up results. In symptomatic (upper limb claudication, transient ischemic attack, vertebrobasilar insufficiency) patients with high-degree (>60%) stenosis, innominate artery PTA was performed. Long-term follow-up was undertaken by blood pressure measurements on both arms as well as subclavian, right common carotid and right vertebral duplex scan. Between 1981 and 1999, the primary success rate of 89 innominate artery PTA (84 stenoses, 5 occlusions) was 96.4%. Complications included one left occipital lobe infarction (2%), two puncture-site thromboses (3%) and four transient ischemic attacks (6%). Two patients with restenosis were successfully treated with re-PTA. Cumulative primary patency was 98 +/- 2% at 6 months, 93 +/- 4% at 16-117 months; secondary patency was 100% at 6 months, 98 +/- 2% at 12-117 months. Sixty-one percent of the patients became symptomless, 32% improved, 7% showed no improvement. Angioplasty of the innominate artery has been proven to be safe and effective on a large series of patients. For innominate artery stenosis and short occlusion, PTA should be the treatment of choice.