Subclavian Steal Phenomenon With Right Hemiparesis A Case Report
Abstract
Subclavian Steal Syndrome results from stenosis of the subclavian artery proximal to the origin of the vertebral artery. This rare disease, commoner in males results in reversal of the
normal direction of blood flow in the vertebral artery from the cerebral circulation. We report a case of a 42 year old female who presented with right sided hemiparesis and history
of giddiness, precipitated by activity involving right upper limb especially with overhead abduction. Radial and Brachial pulsations in right upper limb were absent. Echocardiogram,
MR brain angio, Aortogram and right upper limb arterial Colour Doppler confirmed a right subclavian steal. This rare condition even rarer in females had an unusual right upper limb involvement
instead of the usual left upper limb involvement. Though she had initially presented as a Cerebrovascular accident she was finally found to have a subclavian steal.
References
2. Baloh RW, Honrubia V, editors. Vascular disorders. In Clinical neurophysiology of the vestibular system. 3rd edn. New York: Oxford University Press, 2001; 292-233-308.
3. Perler BA, Becker GJ. Vascular intervention: A clinical approach. London: Thieme;1998:474-5.
4. Sharma VK, Chuah B, Teoh HL, Chan BP, Sinha AK, Robless PA. Chronic brainstem ischemia in subclavian steal syndrome. J Clin Neurosci. 2010;17(10):1339- 41.
5. Parrot JD. The subclavian steal syndrome. Arch Surg. 1969;88:661-5.
6. Reivich M, Holling HE, Roberts B, Toole JF. Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med.1961;265:878.
7. Chan-Tack KM: Subclavian steal syndrome: a rare but important cause of syncope. South Med J. 2001; 94(4): 445–47
8. Aithal J, Ulrich M: Subclavian Steal Syndrome. N Engl J Med. 2012; 10: 363
9. Sagkaguchi S: Syncope associated with exercise. Am J Cardiol. 1995; 75: 476
10. Smith JM, Koury HI, Hafner CD, Welling RE. Subclavian steal syndrome. A review of 59 consecutive cases. J Cardiovasc Surg (Torino), 1994; 35: 11
11. Salam TA, Lumsden AB, Smith RB, 3rd. Subclavian artery revascularization: a decade of experience with extrathoracic bypass procedures. J Surg Res. 1994; 56: 387-92.
12. Hadjipetrou P, Cox S, Piemonte T, Eisenhauer A. Percutaneous revascularization of atherosclerotic obstruction of aortic arch vessels. J Am Coll Cardiol. [Comparative Study] 1999; 33: 1238-45.
13. De Vries JP, Jager LC, Van den Berg JC, Overtoom TT, Ackerstaff RG, Van de Pavoordt ED et al. Durability of percutaneous transluminal angioplasty for obstructive lesions of proximal subclavian artery: long-term results. J Vasc Surg. 2005; 41: 19-23.
14. Sixt S, Rastan A, Schwarzwälder U et al. Results after balloon angioplasty or stenting of atherosclerotic subclavian artery obstruction. Catheter Cardiovasc nterv, 2009; 73: 395.
15. Mahmud E, Cavendish JJ, Salami A. Current treatment of peripheral arterial disease: role of percutaneous interventional therapies. J Am Coll Cardiol. 2007; 50: 473 38.
