Abstract 19688: Longterm Outcomes of Endovascular Therapy for Subclavian Artery Disease in Hemodialysis Patients

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Abstract

Introduction: Clinical outcomes on hemodialysis are little known.

Hypothesis: To investigate the long-term outcome of the endovascular therapy (EVT) for subclavian artery disease in hemodialysis (HD) patients.

Methods: We conducted a sub-analysis of a multicenter retrospective registry (SubClavian Artery disease treated with endovascuLar therapy; muLticenter retrOsPective registry: SCALLOP) of 586 consecutive patients with upper extremity artery disease who underwent EVT between January 2003 and December 2012 at 37 Japanese cardiovascular centers. Seventy-five HD patients (mean 66 ± 10 years, 60 men) who underwent primary EVT for de novo subclavian artery disease. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of death / myocardial infarction (MI)/ stroke, and secondary endpoint was primary patency (defined as treated vessel without restenosis).

Results: The mean follow-up was 39 ± 24 months. Freedom from MACE was significantly different (73%, 50%, 31% at 1, 3, 5 years in HD group and 95%, 88%, 78% in non-HD group, p < 0.001, respectively). However, there was not significant difference in primary patency (84%, 76%, 69% at 1, 3, 5 years in HD group and 90%, 83%, 82% in non-HD group, p = 0.014, respectively). After multivariate analysis, regular dialysis (hazard ratio (HR):3.86, p < 0.001), chronic heart failure (HR:2.13, p = 0.001), coronary artery disease (HR:1.99, p = 0.001), age (per - 10year increase (HR:1.31, p = 0.018) were identified MACE predictors.

Conclusions: Clinical outcomes of angioplasty/stenting for subclavian artery disease in HD patients were feasible in terms of patency but worse in MACE rather than non-HD patients.

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