Subclavian Steal Syndrome

Potter, Brian J.; Pinto, Duane S.

doi:10.1161/circulationaha.113.006653

Cited by 136 publications

(150 citation statements)

References 20 publications

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“…This reversal of flow can occur in an internal mammary artery graft and thus trigger symptoms of cardiac ischemia [4]. Alternatively, patients may present with dizziness, diplopia, ataxia, or syncope due to the reversal of blood flow in the vertebral artery in order to “steal blood from the brain” [5].…”

Section: Discussionmentioning

confidence: 99%

Refractory Hypotension as an Initial Presentation of Bilateral Subclavian Artery Stenosis

Afari

Wylie

Carrozza

2016

Case Reports in Cardiology

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Bilateral subclavian stenosis is a rare clinical condition. An interbrachial pressure difference of 15 mm Hg can raise suspicion for unilateral subclavian artery stenosis, but the diagnosis of bilateral subclavian artery stenosis can be challenging. We present a case of a 75-year-old woman who presented with refractory hypotension after surgery. Initial vitals revealed blood pressure in the 60s/50s mm Hg in both arms. Cardiopulmonary examination was remarkable for diminished pulses in all 4 extremities and audible carotid bruits. She continued to be hypotensive despite aggressive fluid resuscitation. Troponin T peaked at 0.24 ng/mL (reference < 0.04), and an echocardiogram revealed a reduction in ejection fraction (37% from 50%). Left and right heart catheterization demonstrated normal filling pressures and cardiac output. During the procedure, however, it was noted that the patient's central blood pressure was 70–80 mm Hg higher than cuff pressures obtained in either arm. Selective angiography revealed 90% left subclavian ostial stenosis as well as 70% stenosis of the right subclavian artery.

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Section: Discussionmentioning

confidence: 99%

Refractory Hypotension as an Initial Presentation of Bilateral Subclavian Artery Stenosis

Afari

Wylie

Carrozza

2016

Case Reports in Cardiology

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“…Finally, a coronary-subclavian steal phenomenon may occur in patients who have undergone coronary artery bypass graft if a stenosis occurs in the SCA proximal to the takeoff of an internal mammary artery graft utilized to perfuse the heart. If arterial flow demand is increased in another vascular bed, as with ipsilateral upper extremity exercise, a share of the coronary circulation may be ''stolen'', leading to angina or even infarction [5,6].…”

Section: Discussionmentioning

confidence: 99%

Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

Mhamdi

Nakhli

Chelly

et al. 2015

Egyptian Journal of Anaesthesia

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Subclavian steal syndrome (SCSS) has been known since 1960 in the medical literature. Its principal cause is atherosclerosis responsible of occlusion of the subclavian artery (SCA). It is the pathological process in which blood flows in reverse direction from the vertebral artery (VA) to the SCA. Usually asymptomatic, but a variety of symptoms may develop involving the vertebro-basilar and/or the carotid territories and may be precipitated by exercise of the upper extremity. In some circumstances it can be iatrogenic complicating the course of a thoracic endovascular aortic repair (TEVAR) when the left SCA is covered by the endoprosthesis, which is a necessity many times giving the frequent proximity of the acute thoracic pathologies to the origin of this vessel. We present a case of severe headache occurring after a TEVAR with intentional coverage of the origin of the left SCA. This headache was the only symptom from which the patient complained, and which disappeared immediately after carotid-SCA bypass. Other devastating complications can happen, which gave as a concern about the management of SCA when decision to practice a TEVAR is taken.ª 2015 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.

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“…This constellation of symptoms and physical examination findings generally reflects retrograde arterial blood flow and brain hypoperfusion. 1 Arterial duplex ultrasound interrogation of the carotid arteries did reveal a dampened right internal carotid artery signal and retrograde flow in the right vertebral artery. Computed tomography angiography, however, ultimately revealed a significant occlusion in the brachiocephalic artery, with diminished blood flow to the right subclavian artery (Figure 1).…”

Section: Diagnosismentioning

confidence: 95%

Lights Out: An Unusual Case of Amaurosis Fugax

Parsons¹,

Stoner

Doyle

et al. 2018

The American Journal of Medicine

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Subclavian Steal Syndrome

Abstract: The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

Cited by 136 publications

References 20 publications

Refractory Hypotension as an Initial Presentation of Bilateral Subclavian Artery Stenosis

Refractory Hypotension as an Initial Presentation of Bilateral Subclavian Artery Stenosis

Postendovascular thoracic aortic repair subclavian steal syndrome revealed by severe headache

Lights Out: An Unusual Case of Amaurosis Fugax

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