Primary Stenting of Right-Sided Subclavian Artery Stenosis Presenting as Subclavian Steal Syndrome: Report of 3 Cases and Literature Review

Sahsamanis, Georgios; Vourliotakis, George; Pirgakis, Konstantinos M.; Lekkas, Anastasios; Kantounakis, Ioannis; Terzoglou, Alexandra; Tzilalis, Vasilios D.

doi:10.1016/j.avsg.2017.11.033

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…Different diagnostic modalities can be employed for confirmation like Doppler ultrasound, magnetic resonance angiography, or CT‐angiography. Subtraction Angiography can be used therapeutically during the procedure 9 . Diagnostic criteria include occlusion or marked stenosis of subclavian or innominate artery, retrograde vertebral blood flow, and patency of both vertebral and basilar arteries 8 …”

Section: Discussionmentioning

confidence: 99%

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Subclavian steal syndrome secondary to atherosclerosis: A case report and review of literature

Basukala

Pathak

Rijal

et al. 2022

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

“…Subtraction Angiography can be used therapeutically during the procedure. 9 Diagnostic criteria include occlusion or marked stenosis of subclavian or innominate artery, retrograde vertebral blood flow, and patency of both vertebral and basilar arteries. 8 Mildly symptomatic cases can be managed with medical therapy and observation.…”

Section: Discussionmentioning

confidence: 99%

Subclavian steal syndrome secondary to atherosclerosis: A case report and review of literature

Basukala

Pathak

Rijal

et al. 2022

Clinical Case Reports

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“…Numerous case reports have described atherosclerotic SSS [10]. The primary intervention in such cases is percutaneous transluminal angioplasty with stenting [11,12]. Rarely, intravascular procedures can actually precipitate iatrogenic SSS due to prothrombotic vascular injury [13].…”

Section: Figure 3: Mechanism Of Posterior Circulation Insufficiencymentioning

confidence: 99%

Recurrent Subclavian Steal Syndrome: A Novel Case of Vasculopathy

Leach¹,

Radwanski²,

Kaur³

et al. 2023

Cureus

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Subclavian steal syndrome (SSS) refers to the phenomenon of retrograde flow in an ipsilateral branch of the subclavian artery due to hemodynamically significant stenosis or occlusion of the ipsilateral proximal subclavian artery. While SSS is usually asymptomatic, it can manifest as vertebrobasilar insufficiency (VBI), ischemia of the affected extremity, or cardiac angina when an internal mammary artery (IMA) is used as a bypass graft. The underlying etiology is most often atherosclerosis but can include Takayasu arteritis, thoracic outlet syndrome, cervical rib, and stenosis secondary to surgical repair of aortic coarctation or tetralogy of Fallot.There are several case reports describing unique presentations of SSS as well as limited reports of double SSS, where the brachiocephalic steno-occlusive disease causes flow reversal in both the ipsilateral vertebral and carotid arteries. We report herein the first documented case, to our knowledge, of a patient with SSS previously treated with left subclavian artery stenting and left common carotid-subclavian bypass who developed recurrent SSS in conjunction with orthostatic cerebral hypoperfusion syndrome (OCHOS) secondary to severe vasculopathy. She presented with recurrent, paroxysmal vertigo and nearsyncope associated with left upper extremity paresthesias that would only abate with sitting in the context of left subclavian artery stent restenosis and occlusion of her left common carotid-subclavian bypass graft. Interestingly, her initial presentation entailed retrograde flow from the left vertebral artery to the left subclavian artery, classic for SSS, but recurrence of her SSS involved retrograde flow from the left common carotid artery to the left subclavian artery, a phenomenon which has also not been described in the literature to our knowledge. As her symptoms of VBI appeared to be triggered by standing and not left arm movement, they were considered to be primarily secondary to OCHOS. Consequently, her primary treatment was to increase salt and fluid intake and thus increase intravascular volume for improved cerebral perfusion as she was not deemed to be a suitable candidate for regrafting of the left subclavian artery.

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“…Dear Editor, Dialysis access hemorrhage could be fatal and mostly occurs in conjunction with coagulopathy. 1,2 There are reports of bleeding complications from cannulation sites that lead to compartment syndrome. 3 However, subcutaneous bleeding from arteriovenous fistula (AVF) cannulation that compromise skin and tissue perfusion is rarely reported.…”

Section: Fundingmentioning

confidence: 99%

“…In the previous investigations or case reports, the femoral or brachial routes were the preferred approaches to treat subclavian artery stenosis. 1,2 However, the femoral access forces the patient to lie flat without bending the leg for 2-6 h to allow the artery to heal. In some cases, femoral aneurysm, pseudoaneurysm, or internal bleeding can occur and can be severe.…”

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confidence: 99%