No abstract available.
Arteries ; Subclavian Steal Syndrome ; Transplants

No abstract available.
Blood Pressure* ; Pancreatectomy* ; Subclavian Artery* ; Subclavian Steal Syndrome*

We report herein a case of subclavian steal syndrome due to occlusive disease in multiple branches of the aortic arch, which was successfully treated by axilloaxillary bypass and subclavian stent insertion. The hemodynamic changes were evaluated using duplex sonography and transcranial Doppler before and after each procedure. The waveform and parameters of blood flow revealed an objective improvement in cerebral perfusion. These findings correlated well with clinical outcome. Neurosonologic evaluation can provide objective evidence for improved hemodynamic status after treatment.
Aorta, Thoracic ; Hemodynamics ; Perfusion ; Stents ; Subclavian Steal Syndrome

Juxtaductal coarctation is usually distal to the origin of the left subclavian artery, occasionally the orifice of the subclavian artery is involved in the coarctation and partially obstructed. An anomalous origin of the right subclavian artery from the descending aorta below the coarcted segment is also occasionally encountered. Reversed vertebral artery flow to a subclavian artery arising at or below a coarctation may produce the subclavian steal syndrome. Rarely both subclavian arteries arise beyond the coarctation. These abnormal subclavian arteries are important in clinical diagnosis and treatment. We report a case of Turner syndrome with coarctation, which present as juxtaductal type and the left subclavian artery from the descending aorta below the coarcted segment with reversed vertebral artery flow to a subclavian artery producing the subclavian steal syndrome. Resecton of coarctation segment and end-to-end anastomosis was successfully performed after transfer of left subclavian artery to distal segment of descending aorta.
Aorta, Thoracic* ; Aortic Coarctation ; Diagnosis ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Turner Syndrome* ; Vertebral Artery

Although vascular injury after clavicular fracture is a extremely rare, it is a complication which is serious problem. Vascular injury associated with the fracture can be immediate or delayed. We report a case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture and include a review of the literature.
Brachial Artery* ; Cicatrix ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Vascular System Injuries

PURPOSE: To evaluate the characteristic color Doppler imaging of vertebral artery flow in the subclavian steal phenomenon. MATERIALS AND METHODS: The study group consisted of eight patients with reversed vertebral artery flow proved by color Doppler imaging. We classified this flow into two groups : (1) complete reversal ; (2)partial reversal, as shown by Doppler velocity waveform. Vertebral angiography was performed in six of eight patients ; color Doppler imaging and angiographic findings were compared. RESULTS: On color Doppler imaging, all eight cases with reversed vertebral artery flow showed no signal at the proximal subclavian or brachiocephalic artery. We confirmed shunting of six cases by performing angiography from the contralateral verterbral and basilar artery to the ipsilateral vertebral artery. On the Doppler spectrum, six cases showed complete reversal and two partial reversal. On angiography, one partial reversal case showed complete occlusion of the subclavian artery with abundant collateral circulation of muscular branches of the vertebral artery. CONCLUSION: On color Doppler imaging, a reversed vertebral artery suggests the subclavian steal phenomenon. In particular, partial reversal waveform may reflect collateral circulation.
Angiography ; Arteries ; Basilar Artery ; Collateral Circulation ; Humans ; Subclavian Artery ; Subclavian Steal Syndrome* ; Vertebral Artery

BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

PURPOSE: Proximal subclavian artery stenosis is relatively uncommon and usually asymptomatic. It is well known that the retrograde flow through ipsilateral vertebral artery is not related with onset of clinical symptom and not a definite indication of treatment. METHOD: We reviewed six patients including four patients who underwent percutaneous transluminal angioplasty to correct the difference of blood pressure between arms. RESULT: Nobody shows marked clinical improvement even though there was definite technical success. CONCLLUSION: It is considered that angioplasty could be done for the treatment in most of subclavian artery stenosis.
Angioplasty* ; Arm ; Blood Pressure ; Humans ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Vertebral Artery

Though axillo-femoral bypass has been the preferred procedure since the introduction of the procedure by Blaisdell1) in 1963 for high risk patients who have aorto-iliac occlusive disease, widespread use of axillo-femoral bypass was limited in the past because long-term patency rates were inferior to aortofemoral bypass. Multiple mechanisms were mentioned for its inferior patency but delayed stenosis of the inflow artery(not at anastomosis site) were not reported frequently. The authors experienced one case of inflow malfunction of axillo-femoral bypass due to subclavian artery stenosis in a patient with coronary artery disease and carotid artery stenosis. Subclavian artery stenosis was treated by percutaneous transfemoral angioplasty with improvement of symptom and ABI.
Angioplasty ; Carotid Stenosis ; Constriction, Pathologic ; Coronary Artery Disease ; Humans ; Subclavian Artery ; Subclavian Steal Syndrome ; Transplants

A 66 year old man with history of dizziness and occasional headache for a month was found to have right subclavian steal syndrome confirmed by angiogram. Right radial pulse is very weak. Blood pressure on left is 130/70mmHg and on right 70/50. Marked Bruits are audible on right side of neck and shoulder area.
Aged ; Blood Pressure ; Dizziness ; Headache ; Humans ; Neck ; Shoulder ; Subclavian Steal Syndrome*