Color-coded Doppler Imaging of Subclavian Steal Syndrome.

Kaneko, Atsushi; Ohno, R; Hattori, Ken; Furuya, Daisuke; Asano, Yukako; Yamamoto, Toshiyuki; Kim, Hotaek; Shiota, Kunio; Hamaguchi, Katsuhiko

doi:10.2169/internalmedicine.37.259

Cited by 21 publications

(5 citation statements)

References 18 publications

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“…It is not only useful in assessing the severity of the vertebral-steal hemodynamics, but can also show other lesions in the neck vessels. Transcranial Doppler may also be used to further characterize the flow changes in the posterior circulation [38,39]. …”

Section: Screening and Diagnosismentioning

confidence: 99%

A review of subclavian steal syndrome with clinical correlation

Osiro

Żurada²,

Gielecki³

et al. 2012

Med Sci Monit

120

125

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SummarySubclavian ‘steal’ phenomenon is a function of the proximal subclavian artery (SA) steno-occlusive disease, with subsequent retrograde blood flow in the ipsilateral vertebral artery (VA). The symptoms from the compromised vertebrobasilar and brachial blood flows constitute the subclavian steal syndrome (SSS), and include paroxysmal vertigo, drop attacks and/or arm claudication. Once thought to be rare, the emergence of new imaging techniques has drastically improved its diagnosis and prevalence. The syndrome, however, remains characteristically asymptomatic and solely poses no serious danger to the brain. Recent studies have shown a linear correlation between increasing arm blood pressure difference with the occurrence of symptoms. Atherosclerosis of the SA remains the most common cause. Doppler ultrasound is a useful screening tool, but the diagnosis must be confirmed by CT or MR angiography. Conservative treatment is the initial best therapy for this syndrome, with surgery reserved for refractory symptomatic cases. Percutaneous angioplasty and stenting, rather than bypass grafts of the subclavian artery, is the widely favored surgical approach. Nevertheless, large, prospective, randomized, controlled trials are needed to compare the long-term patency rates between the endovascular and open surgical techniques.

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Section: Screening and Diagnosismentioning

confidence: 99%

A review of subclavian steal syndrome with clinical correlation

Osiro

Żurada²,

Gielecki³

et al. 2012

Med Sci Monit

120

125

View full text Add to dashboard Cite

show abstract

“…One of the principal purposes of the pulse Doppler examination of extracranial vertebral arteries is the detection of retrograde blood flow revealing the subclavian steal phenomenon. In previous studies, the subclavian steal phenomenon was found to be more prevalent in the left subclavian artery (LSA) (67–69%) than in the innominate artery [3,4]. The right vertebral artery originates mostly after the origin of the common carotid artery from the innominate artery and rarely from the arch or right common carotid artery [5].…”

Section: Introductionmentioning

confidence: 99%

Correlation between the Degree of Left Subclavian Artery Stenosis and the Left Vertebral Artery Waveform by Pulse Doppler Ultrasonography

Sakima

Wakugawa²,

Isa³

et al. 2010

Cerebrovasc Dis

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Background:Development of retrograde blood flow may be observed in the vertebral artery and is associated with progressive ipsilateral proximal subclavian or innominate artery stenosis. The subclavian steal phenomenon is more prevalent in the left subclavian artery (LSA). The purpose of this study was to analyze the correlation between the degree of LSA stenosis and pulse Doppler waveforms of the left vertebral artery (LVA). Methods:A retrospective analysis of LVA waveforms was performed in 22 cases with LSA proximal stenosis before the origin of the LVA in conventional angiograms. The degree of LSA stenosis was classified into 5 groups (<50, 50–59, 60–69, 70–89, 90–100%). Pulse Doppler waveforms of the LVA were also classified into 5 subtypes depending on the depth of the mid-systolic notch representing retrograde blood flow (normal, mid-systolic notch, retrograde flow smaller than antegrade flow, retrograde flow larger than antegrade flow, retrograde flow without antegrade flow). Results:A statistically significant correlation (R² = 0.646, p < 0.0001) was found between the degree of LSA stenosis and the LVA waveform. Conclusions:The pattern analysis of LVA pulse Doppler waveforms seems to be useful in determining the degree of LSA stenosis.

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“…Subclavian steal syndrome is mostly seen in men over the age of 55, and while the left side is predominant; our case was that of a 34-year-old female patient with subclavian steal syndrome on the right side. 7,11 Subclavian steal syndrome is generally asymptomatic and diagnosed incidentally via examination 2 . In subclavian steal syndrome, narrowing of the subclavian artery proximal to the vertebral artery results in a pressure difference between the subclavian artery and the basilar artery.…”

Section: Discussionmentioning

confidence: 99%