A case of acquired right-sided subclavian steal syndrome successfully treated with stenting using brachial approach

Abstract

Subclavian steal syndrome (SSS) is defined as a group of symptoms that arise from reversed blood flow in the ipsilateral vertebral artery. It is the consequence of proximal occlusion or highgrade stenosis of the subclavian artery. The subclavian obstructive lesions are mostly located in the proximal segment of the subclavian artery and predominantly on the left side. In contrast, there are only a small number of patients that present with right-sided symptoms and even fewer with bilateral symptoms. Endovascular therapy of occlusions and high-grade stenosis of subclavian artery proximal to the origin of the vertebral artery becomes an established therapy in last two decades. We report a case of successful endovascular treatment of right-sided subclavian steal and high-grade (80%) right subclavian artery stenosis due to atherosclerotic occlusive disease with balloon-expandable stent using brachial approach.

Percutaneous treatment of right-sided subclavian stenosis using radial approach

“…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.…”

“…The Journal of Vascular Access 20 (2) for peripheral intervention has some limitations needed to be discussed. First, the smaller vessel diameter.…”

“…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.…”

Subclavian artery stenting via bilateral radial artery access: Four case reports

“…Moreover, there are also some rare complications, such as retroperitoneal hemorrhage. PTA and subclavian artery stenting via brachial approach has also been attempted to overcome those shortcomings[ 6 ]. However, previous studies have shown that brachial artery is mainly used as the blood supply to the upper extremity, with a high incidence of complications in access sites and ischemic complications[ 7 ].…”