Subclavian steal syndrome

Introduction: Subclavian steal syndrome occurs through subclaviculare artery stenosis before emerging vertebral artery. The most common cause is atherosclerosis and the severity of the polivascular damage determines the prognosis of the disease. We present the case of a patient aged 54, smoker, with no significant pathologic personal history, which was presented for dizziness, two episodes of lipothimy, paresthesia and pain in the left upper limb, with the debut of about 2 months. Methods: Clinical examination revealed the difference in systolic blood pressure right arm (Sbp = 140 mm Hg)\\/left arm (Sbp = 70 mm Hg) pulse weak perceptible on the left radial artery. Biologically: hypercholesterolemia and impaired glucose tolerance. ECG and holter ECG – without significant changes. Echocardiography: diastolic dysfunction of VS, with preservation of systolic function. Arterial Doppler ultrasound examination in the left upper limb showed low flow speeds in the brachial artery and subclavian artery high beams after emerging. Arteriography reveals the left subclavian artery occlusion after origin with recharging it after left vertebral artery emerging and vertebral artery flow reversed on the left. Results: The left subclavian artery angioplasty was performed with self expandable stent implantation and was given treatment with statin and dual antiplatelet, with subsequent favorable evolution. Conclusions: Primary success by stenting, in such cases, exceeds 95%, and the long-term prognosis is generally favorable and is conditioned mainly by controlling cardiovascular risk factors.

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