ABSTRACT
Subclavian steal syndrome is a group of symptoms resulting fromretrograde flow in the vertebral artery, "stealing" blood from the posterior intracranial circulation and other territories, caused by stenosis or occlusion of the subclavian artery proximal to the origin of the same vertebral artery, or even of the brachiocephalic trunk. Most of the time, it is an incidental finding in patients with other conditions or cerebrovascular risk factors. We report a series of 29 patients with an angiographic diagnosis, in which 7 received treatment (all endovascular), all with symptoms directly related to this condition. Advanced age, systemic arterial hypertension, diabetes mellitus, smoking and stroke were comorbidities frequently related. Six patients improved completely after the procedure and one remained with vertigo.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Subclavian Artery/abnormalities , Subclavian Steal Syndrome/physiopathology , Subclavian Steal Syndrome/therapy , Subclavian Steal Syndrome/diagnostic imaging , Brazil/epidemiology , Medical Records , Epidemiology, Descriptive , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Angioplasty/methodsABSTRACT
When the proximal occlusion or stenosis of the subclavian or of the brachiocephalic artery may require distal arterial filling through reversal flow from the vertebral artery, causing clinically significant blood supply reduction to the brainstem, it is called subclavian steal syndrome (SSS). We report a 54-year-old male patient who presented with multiple episodes of syncopes and vascular claudication due to right SSS. He underwent an angioplasty, evolving with complete improvement of the symptoms. We review the clinical presentation, the diagnosticmethods, and the treatment options of the disease.
Subject(s)
Humans , Male , Middle Aged , Subclavian Artery/abnormalities , Subclavian Steal Syndrome/diagnosis , Subclavian Steal Syndrome/physiopathology , Subclavian Steal Syndrome/therapy , Syncope , Endovascular Procedures/methodsABSTRACT
Background Fibromuscular dysplasia (FMD) affects predominantly the cervical and renal arteries and may cause the classical angiographic pattern of string-of-beads. The diagnosis is increasing with the advances of imaging techniques. Case Report A 37-year-old man presenting with subarachnoid hemorrhage due to a dissecting aneurysm of the vertebral artery was treated by angioplasty with stent, with good outcome. All of the cervical and renal arteries were diseased and showed dysplasia and/or ectasias. Conclusions There are no guidelines or protocols to treat patients with FMD.