[Positional deformity of the subclavian artery as a possible cause of subclavian steal syndrome]. / Pozitsionnaia deformatsiia podkliuchichnoi arterii kak vozmozhnaia prichina podkliuchichnogo steal-sindroma.

Using the method of duplex scanning, we examined a total of 123 patients presenting with a deformity of the subclavian artery (SCA). We assessed the Doppler spectrum of blood flow in the zone of the SCA deformity, as well as in V2 and V4 segments of the ipsilateral vertebral artery (VA) at rest and in breath holding on inspiration. Deformity of the SCA was observed on the right in 91% of cases, on the left in 5%, and on both sides in 4%. Haemodynamic disorders in the ipsilateral VA as a change of the shape of the Doppler spectrum according to the type of steal syndrome were noted in 10.8% of cases, with a more pronounced impairment of blood flow at the intracranial level - in 78.6% of cases. It was determined that a deformity of the SCA was characterised by a decrease in angulation (up to complete straightening) and a reduction of the peak systolic velocity on deep inspiration, thus reflecting its positional nature. Patients with initial impairment of the Doppler spectrum in the VA demonstrated normalization of the spectrum on an intake of breath. Hence, the index of the peak systolic velocity of blood flow in the zone of the SCA deformity in combination with assessment of the Doppler spectrum in the ipsilateral VA on inhalation may be used for determining the haemodynamic significance of a deformity of the SCA.

Deformity of subclavian artery as a cause of formation of vertebral subclavian steal syndrome.

Presented herein are 3 clinical case reports concerning formation of vertebral subclavian steal syndrome in deformities of subclavian arteries. By means of duplex scanning, angiography and multispiral computed tomography it was shown that deformities of subclavian arteries in the first segment (proximal to the origin of the vertebral artery) with septal stenosing are accompanied by a typical dopplerographic picture_pattern of steal syndrome.

[Helical (spiral or swirling) blood flow in cardiovascular system].

In article covers theoretical preconditions for the hypothesis about helical (spiral or swirling) blood flow in cardiovascular system followed by its experimental corroboration. The role of the modern blood flow visualization methods--such as Color Doppler ultrasound and magnetic-resonance angiography--in registration and investigation of the regularities of the given phenomenon is described. The data describing the known parameters of helical blood flow--such as direction of the rotation and its quantitative parameters in large arteries--are given. The main hypotheses for flow screw mechanisms are considered from the point of view of cardiovascular system structural organization. Biological role of helical blood flow is discussed, in respect of which there are diametrically opposed points of view, which consider it as a physiological phenomenon on one side, and as a patogenetic factor of atherosclerosis development on the other.

[Formation of vertebral-subclavian steal syndrome in abnormal origin of the left vertebral artery from the aortic ark].

Presented herein is a clinical case report concerning the formation of vertebral-subclavian steal syndrome combined with occlusion of the left subclavian artery and an abnormal origin of the left vertebral artery from the aortic arch. Duplex scanning data and angiography findings showed that the collateral compensation of haemocirculation in the upper extremity took place through the subclavian-vertebral collateral net. Doppler ultrasonography signs of the latent steal syndrome were revealed in the intracranial segment of the left vertebral artery and were confirmed by the findings of the reactive hyperthermia test. Balloon angioplasty with stenting of the 1st portion of the left subclavian artery resulted in normalization of the Doppler spectrum in the intracranial segment of the left vertebral artery.

[Basic laws of blood screw motion in human common carotid arteries].

The basic laws of blood screw motion in common carotid arteries in people were determined by means of modern ultrasound techniques for the first time. 92 healthy adults, aged 18-30, were examined. The blood flow in the middle one-third of common carotid arteries was registered by means of Color Doppler Imaging and impulse Doppler with the help of ultrasound Medison 8000EX scanner by linear transducer of 5-9 MHz. The steady registration of blood screw motion in both common carotid arteries in Color Doppler Imaging regimen was observed in 54.3 % of cases. The direction of screw stream rotation in most cases (54%) was multi-directed: in the right common carotid artery it was right, in the left common carotid artery--left (48%), and in 6% of cases it was reverse. For 46% of cases blood rotation in both common carotid arteries was one-directed (26%--right, 20%--left). The velocity parameters of rotation component of blood motion were determined, maximum velocity being 19.68 +/- 5.84 cm/sec, minimum--4.57 +/- 2.89 cm/sec, average--7.48 +/- 2.49 cm/sec, angular--10.7 +/- 2.49 sec(-1). The rated velocity of blood cells motion in screw motion with regard of screw current lines to the vessel vertical axis makes up from 158.67 +/- 32.79 to 224.39 +/- 46.37 cm/sec.