Is the general practitioner hospital a potential "patient trap"? A panel study of emergency cases transferred to higher level hospitals

PURPOSE: Assessment of the technical success and mid-term success of PTA of brachiocephalic occlusive disease. MATERIAL AND METHODS: 24 patients, who were treated interventionally because of stenoses of the brachiocephalic arteries were enrolled into this prospective study. In total there were 27 lesions (26 arteriosclerotic lesions and one dissection with pseudoaneurysma). 18 lesions were located in the subclavian artery (extending into the axillar artery in one case), 4 in the brachiocephalic trunk, three in the common carotid artery and two in the vertebral artery. As adjunctive to balloon dilatation 8 stents were implanted. RESULTS: Technical success was achieved in 24/27 lesions. There was an embolic complication in one of 27 interventions. 15/24 patients with 17 treated lesions underwent control angiography with a mean follow-up of 14 months. Follow-up angiography revealed one occlusion and three significant restenoses. 5/24 patients agreed only to clinical follow-up and Doppler examinations, three were lost and one patient died. CONCLUSION: PTA of brachiocephalic occlusive disease showed good technical success. Additional implantation of stents may be useful. Midterm success is satisfactory.