ABSTRACT
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.
Subject(s)
Subclavian Steal Syndrome/diagnosis , Subclavian Steal Syndrome/therapy , Vascular Surgical Procedures , Cardiology , Humans , Subclavian Steal Syndrome/diagnostic imaging , UltrasonographyABSTRACT
OBJECTIVE: To present two case reports that the authors believe demonstrate the creation of autoimmune hearing loss in a healthy ear in response to endolymphatic sac surgery in an opposite ear felt to be afflicted with Ménière's Disease. In both cases, unexpected trama was incurred in performing the original surgery for endolymphatic sac decompression. STUDY DESIGN: Two case reports. SETTING: Ambulatory office and hospital in a tertiary referral center. PATIENTS: Two patients selected for their unique development of autoimmunity in the ear that was not operated on. INTERVENTIONS: Surgical intervention (endolymphatic sac surgery) for Ménière's Disease. MAIN OUTCOME MEASURES: Audiometry and clinical assessment. RESULTS: Audiometric results of two patients believed to have developed autoimmune sensorineural hearing loss as the result of surgical trauma delivered to the patient's opposite ear. CONCLUSION: It is believed that the two patients presented developed autoimmune sensorineural hearing loss in an opposite nonsurgical ear in response to surgical intervention (believed to be traumatic) in their original Ménière's Disease ear.
