//fpnotebook.com/
Subclavian Steal Syndrome
Aka: Subclavian Steal Syndrome
- Epidemiology
- Age over 55 years
- More common in men than women by ratio of 2 to 1
- Risk Factors
- Vigorous Exercise of affected extremity
- Similar to Cardiac Risk Factor
- Hypertension
- Diabetes Mellitus
- Hyperlipidemia
- Tobacco use
- Pathophysiology
- Proximal subclavian artery Occlusion
- Vertebral Artery supplies retrograde flow
- Results in decreased Blood Flow to posterior brain
- Causes
- Arteriosclerosis of subclavian artery (95% of cases)
- Dissecting Aortic Aneurysm
- Embolism
- Takayasu's Arteritis
- Symptoms
- Vertebrobasilar Insufficiency
- Light-headedness or Dizziness
- Ataxia or Vertigo
- Visual disturbance
- Motor deficit
- Confusion
- Focal Seizure
- Aphasia
- Headache
- Syncope
- Subclavian Insufficiency (onset after CNS symptoms)
- Arm weakness
- Arm coldness or Paresthesias
- Arm Claudication with Exercise
- Provocative Maneuvers
- Vigorous Exercise of affected arm
- Sudden turning of head to affected side
- Signs
- Diminished radial and ulnar pulses on affected side
- Blood Pressure difference >20 mmHg between arms
- Subclavian bruit
- Radial pulse disappears on arm Exercise or elevation
- Radiology
- Carotid Ultrasound
- Magnetic resonance angiography
- Arch Aortography
- Management: Surgical Options
- Axillo-axillary bypass
- Carotid-Subclavian bypass
- Percutaneous transluminal Angioplasty with stenting
- Prevention
- See Hypertension Management
- See Diabetes Mellitus Management
- Tobacco Cessation
- References
- Chan-Tack (2001) South Med J 94:445-7