Subclavian Steal Syndrome

Gorman, James; Navarre, J. Robert; McLEAN, Hal

doi:10.1001/archsurg.1964.01310210024003

Cited by 26 publications

(9 citation statements)

References 7 publications

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“…3,4 As a result, patients affected with this disease are at increased risk of developing symptomatic coronary artery disease and cerebrovascular events. [5][6][7] The left subclavian artery is four times more likely to be affected than the right or innominate arteries. 3,8,9 If there is an isolated stenosis, due to the degree of potential collateralization, the likelihood of symptoms is less than in other vascular beds.…”

mentioning

confidence: 99%

Subclavian artery stenosis: A review for the vascular medicine practitioner

2010

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Peripheral artery disease assessment typically focuses on the evaluation of lower extremity symptoms and physical findings. Few practitioners consider the importance of upper extremity arterial disease; which, besides causing hand and arm symptoms, can be associated with significant neurologic and cardiac sequelae. A review of the existing literature through PubMed using the search term 'subclavian stenosis' was performed. The latest original articles, including clinical studies, case reports and limited reviews of this topic were adapted. A comprehensive article review focusing on the diagnostic and treatment approach for subclavian stenosis was prepared. In conclusion, vascular medicine practitioners including cardiologists and vascular surgeons caring for patients with arterial disease should routinely assess for subclavian stenosis. There are excellent screening tools and effective medical therapies which can be instituted if diagnosed early. When the need for revascularization arises, percutaneous modalities are favored given their proven long-term efficacy, decreased morbidity and mortality, and cost-effectiveness.

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confidence: 99%

Subclavian artery stenosis: A review for the vascular medicine practitioner

2010

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“…4,[15][16][17] However, clinical ischemic symptoms develop when the collateral circulation to the upper extremity is unable to compensate for a decrease in blood supply as a result of anatomical variation or occlusive disease in the carotid, vertebral, or circle of Willis arteries. 4,5 In these circumstances, surgical or endovascular treatment of the subclavian artery lesion is indicated.…”

Section: Discussionmentioning

confidence: 99%

“…The phenomenon of reversed flow in the vertebral artery in the setting of proximal subclavian artery stenosis 1,2 is relatively rare and usually asymptomatic 3 due to adequate compensation by the circle of Willis and a rich brachiocephalic collateral circulation. However, symptoms can arise when these pathways are compromised by occlusive disease or anatomical variants, 4,5 leading to vertebrobasilar or upper extremity ischemia or even myocardial ischemia from diminished flow through an internal mammary artery bypass graft. 4,6,7 In these circumstances, surgical or endovascular intervention is indicated.…”

Section: ¤ ¤mentioning

confidence: 99%

Endovascular Stenting vs. Extrathoracic Surgical Bypass for Symptomatic Subclavian Steal Syndrome

Song¹,

Zhang²,

Li³

et al. 2012

Journal of Endovascular Therapy

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“…The endpoints of the study were hemodynamically significant or symptomatic subclavian stenosis. A hemodynamically significant lesion was identified by a blood pressure difference between the arms Ն20 mmHg, 16 confirmed by abnormal oscillography and documentation of a stenotic flow pattern or stenosis on duplex scans or angiograms. 19 Symptomatic subclavian artery stenosis referred to a hemodynamically significant stenosis in a patient with exercise-dependent upper limb ischemic or embolic symptoms.…”

Section: Definitionsmentioning

confidence: 99%

“…Yet, symptomatic patients may become asymptomatic over time with conservative therapy. 15,16 How then do we decide if angioplasty is appropriate in patients with symptoms referable to subclavian occlusive disease? On the one hand, a more conservative approach would be to restrict procedural intervention only for patients with severe symptoms.…”

mentioning

confidence: 99%