Brachiocephalic and subclavian stenosis: Current concepts for cardiovascular specialists

AbstractThe persistent hypoglossal artery is rare vascular anomalies. We report the case of a 50-year old man with right hypoglossal artery, ipsilateral hypoplasic internal carotid artery, associated with left proximal subclavian stenosis with subclavian steal syndrome. Power-Doppler-Ultra-Sonography spectral images obtained after the patient exercised the left arm showed mid-systolic deceleration with retrograde late-systolic velocities. A Computed Tomography Angiography demonstrated a proximal stenosis of the left SA, a mild right ICA hypoplasia and an anomalous artery arising from right ICA at C2–C3 level, entering the cranium via the hypoglossal canal and joining the basilar artery. Usually the presence of PHA may be completely asymptomatic, and detected as an incidental finding by CTA or MRA, but in our case its diagnosis is extremely important because it is often the only vessel supplying blood to the basilar trunk and posterior circulation.

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Collateral circulation in subclavian stenosis or atresia

The American Journal of Cardiology ◽

10.1016/0002-9149(66)90016-6 ◽

1966 ◽

Vol 18 (4) ◽

pp. 599-604 ◽

Cited By ~ 23

Author(s):

Asuquo U. Antia ◽

Ole E. Ottesen

Keyword(s):

Collateral Circulation ◽

Subclavian Stenosis

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Letter: Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opab247 ◽

2021 ◽

Author(s):

Yoshiki Hanaoka ◽

Daisuke Yamazaki ◽

Jun-ichi Koyama ◽

Tetsuyoshi Horiuchi

Keyword(s):

Vertebral Artery ◽

Transfemoral Approach ◽

Subclavian Stenosis

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Basilar Artery Blood Flow in Subclavian Steal

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100028171 ◽

1988 ◽

Vol 15 (4) ◽

pp. 417-419 ◽

Cited By ~ 14

Author(s):

Natan M. Bornstein ◽

Adam Krajewski ◽

John W. Norris

Keyword(s):

Blood Flow ◽

Vertebral Artery ◽

Basilar Artery ◽

Transcranial Doppler ◽

The Other ◽

Artery Blood Flow ◽

Subclavian Steal ◽

Doppler Techniques ◽

Subclavian Stenosis ◽

Age And Sex

ABSTRACT:Subclavian “steal”, when blood siphons from one vertebral artery to the other, has been suggested as a cause of brain stem ischaemia and stroke. We investigated 33 patients using transcranial Doppler to determine the direction and velocity of basilar blood flow. All patients had severe subclavian stenosis with reversed vertebral blood flow in the ipsilateral artery previously demonstrated by extracranial Doppler. Basilar flow was normal in direction in all cases, but its velocity was significantly increased (p<0.0008) compared to age- and sex-matched controls. These findings, in conjunction with previous observations using extracranial Doppler techniques, suggest that subclavian steal is little more than a harmless haemodynamic phenomenon.

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