Subclavian Artery Disease: Diagnosis and Therapy

Saha, Tisa; Naqvi, Syed Yaseen; Ayah, Omar; McCormick, Daniel J.; Goldberg, Sheldon

doi:10.1016/j.amjmed.2016.12.027

Cited by 31 publications

(31 citation statements)

References 42 publications

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“…This steal phenomenon can result in angina or myocardial infarction due to the temporary reversal in blood flow from the coronary artery. A similar phenomenon can occur with vertebrobasilar-subclavian steal syndrome, where blood flow is "stolen" from the brain, and neurologic symptoms predominate [6]. Subclavian artery stenosis itself is estimated to occur in up to 54% of those with peripheral vascular disease, although it is often asymptomatic [7].…”

Section: Discussionmentioning

confidence: 95%

An Interesting Case of a Cold Left Arm

Hmiel

Németh

2020

Cureus

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Inter-arm variability in blood pressure readings typically signifies arterial disease between the aortic arch and the subclavian artery. The differential diagnosis includes thoracic aortic dissection, atherosclerosis, thoracic outlet syndrome, and subclavian artery stenosis and thrombosis. In patients with prior coronary artery bypass grafting, including the internal mammary artery, several of those conditions can compromise coronary blood flow and lead to myocardial ischemia. Here we discuss a case of left subclavian artery thrombosis, which compromised left internal mammary artery blood flow and led to ischemic ventricular tachycardia.

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Section: Discussionmentioning

confidence: 95%

An Interesting Case of a Cold Left Arm

Hmiel

Németh

2020

Cureus

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“…Its most common aetiology is atherosclerosis, but it can also result from Takayasu arteritis, compression syndrome and fibromuscular dysplasia [1–3]. The left subclavian artery is four times more likely to be affected than the right or innominate arteries [3]. Patients with SAS, as suspected by inter-arm BP difference, had a higher incidence of future cardiovascular events in a large community-based cohort [9].…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms related to SAS include arm claudication, pain while resting, finger necrosis from embolic debris and syncope due to subclavian steal syndrome [2, 3]. In a patient with CABG using IMA, angina pectoris may present due to decreased perfusion pressure [2, 3, 5, 6, 8].…”

Section: Discussionmentioning

confidence: 99%

Pseudo-hypotension with acute pulmonary oedema due to simultaneous bilateral subclavian artery stenosis in a patient with coronary artery bypass graft surgery using bilateral internal mammary arteries: a case report

Hirata

Nakazato

Wake

et al. 2019

Oxford Medical Case Reports

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A 75-year-old woman, with a history of bilateral internal mammary artery–coronary artery bypass graft surgery, developed hypotension and pulmonary oedema posing as cardiogenic shock. Severe bilateral subclavian artery stenosis emerged to be the cause of ischaemic myocardial dysfunction and heart failure. An emergency endovascular treatment was successfully performed. The presence of simultaneous bilateral subclavian artery narrowing as the pathophysiologic mechanism of myocardial ischaemia makes this case remarkable.

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“…10 Nearly up to a third of patients with SAA were asymptomatic. 11 Saliou and his team explained that intrathoracic SAA is largely asymptomatic and difficult to detect on physical examination, and that symptoms may be directly related to the size of the aneurysm. 12 However, upon reviewing previous studies, we found that the diagnosis of SAA was mostly achieved through advanced imaging examination, which gave the message of the location and size of SAA.…”

Section: Disscusionmentioning

confidence: 99%

Subclavian steal syndrome without Stenosis: A Case Report and Review of the Literature

Lou¹,

Jin²,

Yang³

et al. 2020

Preprint

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Background："Stealing" of the subclavian artery is a phenomenon where proximal subclavian artery stenosis or occlusion causes retrograde blood flow in the ipsilateral vertebral artery. This, combined with ischemic symptoms of vertebrobasilar arteries or ipsilateral upper limb artery, is called subclavian steal syndrome. Sometimes, subclavian steal syndrome can occur in patients without subclavian artery stenosis, such as in patients with high-flow arteriovenous dialysis fistulas or subclavian artery aneurysms. Interestingly, compared with classic atherosclerotic subclavian steal syndrome, the former patient is more prone to symptoms like paroxysmal vertigo, drop attacks, diplopia, and arm claudication. Case Presentation ： In our case, we present a 35-year-old male who suffered from paroxysmal vertigo. Clinical physical examination did not reveal any substantial evidence of proximal subclavian artery stenosis. Transcranial Doppler and ultrasonography revealed an abnormal blood flow pattern in the right vertebral artery, consistent with partial subclavian steal syndrome. Ultrasonography and computed tomography angiography showed no stenosis in the right subclavian artery and three aneurysms in the proximal segment. The hypoplastic vertebral artery originated from the third aneurysm. Conclusions ： There are few reports of subclavian steal syndrome caused by subclavian aneurysms in the literature; our case is the first to report partial subclavian steal syndrome caused by multiple aneurysms. Following a literature review, combined with our analysis of this case, we suggest that subclavian artery aneurysm which induced subclavian steal syndrome is an often unnoticed cause of vertigo.

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Subclavian Artery Disease: Diagnosis and Therapy

Cited by 31 publications

References 42 publications

An Interesting Case of a Cold Left Arm

An Interesting Case of a Cold Left Arm

Pseudo-hypotension with acute pulmonary oedema due to simultaneous bilateral subclavian artery stenosis in a patient with coronary artery bypass graft surgery using bilateral internal mammary arteries: a case report

Subclavian steal syndrome without Stenosis: A Case Report and Review of the Literature

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