scholarly journals A clampless anastomosis technique using the aortic cannula mounted by a prosthetic graft for a severely calcified aorta in a patient with subclavian steal syndrome

2019 ◽  
Vol 56 (5) ◽  
pp. 1018-1020
Author(s):  
Kohei Sumi ◽  
Shigehiko Yoshida ◽  
Yoshitaka Okamura ◽  
Hideki Kunimoto
Keyword(s):  
High Risk ◽  
Vertebral Artery ◽  
Prosthetic Graft ◽  
Embolic Stroke ◽  
Subclavian Steal Syndrome ◽  
Surgical Strategies ◽  
Subclavian Steal ◽  
Aortic Cannula ◽  
Calcified Aorta ◽  
Steal Syndrome

Abstract Patients with severely calcified aorta are at high risk of embolic stroke during surgery and it is not feasible to clamp the aorta, necessitating alternative surgical strategies. We present a clampless anastomosis technique using the aortic cannula mounted by a prosthetic graft for a severely calcified aorta in a patient with subclavian–vertebral artery steal syndrome.

Subclavian steal syndrome

1979 ◽  
Vol 51 (5) ◽  
pp. 628-640 ◽  
Author(s):  
George L. Bohmfalk ◽  
Jim L. Story ◽  
Willis E. Brown ◽  
Arthur E. Marlin
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Vertebral Artery ◽  
Upper Extremity ◽  
Common Carotid Artery ◽  
Subclavian Steal Syndrome ◽  
Artery Ligation ◽  
Subclavian Steal ◽  
The Brain ◽  
Steal Syndrome

✓ Three patients with central nervous system symptoms due to subclavian steal syndrome were treated with proximal vertebral to common carotid artery transposition. Neurological symptoms were relieved or improved in all three, with no decrease in blood pressure or pulse in the ipsilateral upper extremity. The colorful history of this syndrome is reviewed, and the various surgical approaches to its treatment are discussed. Although the literature suggests that the commonly used carotid to subclavian artery bypass graft and other similar extrathoracic procedures are generally safe and effective for relief of symptoms of the steal, there is also evidence that these bypasses may fail to restore antegrade flow in the vertebral artery, and, in fact, may steal from the carotid artery. Thus, the blood flow provided to the brain by these procedures may be hardly more than that provided by vertebral artery ligation, whereas the principal effect is to restore blood flow into the upper extremity. Vertebral artery ligation alone has been used in 20 patients, with neurological improvement in all cases and production of persistent intermittent brachial claudication in only one. These considerations and our patient experience suggest that a relatively simple operation, proximal vertebral to common carotid artery transposition, which emphasizes restoration of flow to the brain rather than to the upper extremity, may be preferable for most patients with neurological symptoms of subclavian steal syndrome.

scholarly journals Ruptured vertebrobasilar junction aneurysm unmasking subclavian steal syndrome

2020 ◽  
Vol 11 ◽  
pp. 419
Author(s):  
Vivek Murumkar ◽  
Shumyla Jabeen ◽  
Sameer Peer ◽  
Aravinda Hanumanthapura Ramalingaiah ◽  
Jitender Saini
Keyword(s):  
Vertebral Artery ◽  
Subclavian Artery ◽  
Subclavian Steal Syndrome ◽  
Left Vertebral Artery ◽  
Vertebrobasilar Insufficiency ◽  
Subclavian Steal ◽  
Subclavian Artery Occlusion ◽  
Retrograde Filling ◽  
Vertebrobasilar Junction ◽  
Steal Syndrome

Background: Subclavian steal occurs due to stenosis or occlusion of the subclavian artery or innominate artery proximal to the origin of the vertebral artery. Often asymptomatic, the condition may be unmasked due to symptoms of vertebrobasilar insufficiency triggered by strenuous physical exercise involving the affected upper limb. The association of vertebrobasilar junction (VBJ) aneurysms with subclavian steal syndrome has been rarely reported. Hereby, we present a case of VBJ aneurysm associated with subclavian steal treated successfully with endovascular coiling. Case Description: A 65-year-old female presented in the emergency department with acute severe headache and vomiting with no focal neurological deficits. Non-contrast computed tomography of the brain showed modified Fischer Grade 3 subarachnoid hemorrhage. Subsequent digital subtraction angiogram (DSA) showed VBJ aneurysm directed inferiorly with the left subclavian artery occlusion. There was retrograde filling of the left vertebral artery on right vertebral injection, confirming the diagnosis of subclavian steal. Balloon assisted coiling of the VBJ aneurysm was performed while gaining access through the stenotic left vertebral artery ostium which provided a more favorable hemodynamic stability to the coil mass. Conclusion: Subclavian steal exerting undue hemodynamic stress on vertebrobasilar circulation can be an etiological factor for the development of the flow-related aneurysms. Access to the VBJ aneurysms may be feasible through the stenosed vertebral artery if angioplasty is performed before the coiling of the aneurysm.

Subclavian steal syndrome

1979 ◽  
Vol 51 (5) ◽  
pp. 641-643 ◽  
Author(s):  
George L. Bohmfalk ◽  
Jim L. Story ◽  
Willis E. Brown ◽  
Arthur E. Marlin
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Common Carotid Artery ◽  
Subclavian Steal Syndrome ◽  
Flow Rates ◽  
Content Type ◽  
Subclavian Steal ◽  
Before And After ◽  
Antegrade Flow ◽  
Steal Syndrome

✓ Intraoperative vertebral artery blood flow was measured in two patients with symptomatic subclavian steal syndrome, before and after proximal end-to-side vertebral to common carotid artery transposition. This confirmed retrograde flow in the vertebral artery before transposition, and antegrade flow after transposition. The measured flow rates were compared to values in other series involving different operative procedures for correction of symptomatic subclavian steal. The greatest mean antegrade flow rates in the vertebral artery were restored by proximal end-to-side vertebral to common carotid artery transposition.

scholarly journals High-Risk Acute Coronary Syndrome in a Patient with Coronary Subclavian Steal Syndrome Secondary to Critical Subclavian Artery Stenosis

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Zaher Fanari ◽  
Niksad Abraham ◽  
Sumaya Hammami ◽  
Wasif A. Qureshi
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Cardiogenic Shock ◽  
Subclavian Artery ◽  
Left Ventricular ◽  
Subclavian Steal Syndrome ◽  
Coronary Syndrome ◽  
Subclavian Steal ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

Patients with multivessel coronary artery disease are more likely to have extensive atherosclerosis that involves other major arteries. Critical subclavian artery (SCA) stenosis can result in coronary subclavian steal syndrome that may present as recurrent ischemia and even myocardial infarction in patients with coronary artery bypass graft (CABG). In patients with concomitant severe native coronary disease, occluded saphenous venous grafts (SVG) to other arteries, percutaneous intervention on critical subclavian artery (SCA) stenosis that will compromise the blood flow to left internal mammary graft (LIMA) and left anterior descending (LAD) artery will be a high-risk procedure and may be associated with cardiogenic shock, especially in patients with preexisting ischemic cardiomyopathy. The use of percutaneous left ventricular (LV) assist device like Impella will offer better hemodynamic support and coronary perfusion and therefore results in decreased myocardial damage, maximized residual cardiac function, and lower incidence of cardiogenic shock.

scholarly journals Endovascular Treatment in the Subclavian Steal Syndrome: Series of 29 Patients

2021 ◽  
Author(s):  
Luana Antunes Maranha Gatto ◽  
Diego do Monte Rodrigues Seabra ◽  
Gabriel Angelo Garute Zenatti ◽  
Letícia Frose ◽  
Gelson Luis Koppe ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Incidental Finding ◽  
Subclavian Steal Syndrome ◽  
Retrograde Flow ◽  
Subclavian Steal ◽  
Brachiocephalic Trunk ◽  
Cerebrovascular Risk ◽  
Steal Syndrome ◽  
Intracranial Circulation ◽  
Angiographic Diagnosis

AbstractSubclavian steal syndrome is a group of symptoms resulting from retrograde flow in the vertebral artery, “stealing” blood from the posterior intracranial circulation and other territories, caused by stenosis or occlusion of the subclavian artery proximal to the origin of the same vertebral artery, or even of the brachiocephalic trunk. Most of the time, it is an incidental finding in patients with other conditions or cerebrovascular risk factors. We report a series of 29 patients with an angiographic diagnosis, in which 7 received treatment (all endovascular), all with symptoms directly related to this condition. Advanced age, systemic arterial hypertension, diabetes mellitus, smoking and stroke were comorbidities frequently related. Six patients improved completely after the procedure and one remained with vertigo.

Subclavian steal syndrome in a hemodialysis patient after percutaneous transluminal angioplasty of arteriovenous access

2018 ◽  
Vol 19 (4) ◽  
pp. 404-408 ◽  
Author(s):  
Yoko Kaneko ◽  
Takamoto Yanagawa ◽  
Yoshinori Taru ◽  
Sonoko Hayashi ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
High Flow ◽  
Subclavian Steal Syndrome ◽  
Left Vertebral Artery ◽  
Subclavian Steal ◽  
Percutaneous Transluminal ◽  
Steal Syndrome

Introduction: We describe a hemodialysis patient who developed subclavian steal syndrome via an arteriovenous fistula after percutaneous transluminal angioplasty. Case description: A 55-year-old female with end-stage renal failure due to polycystic kidney disease had been treated with hemodialysis for 10 years. Because of an autologous arteriovenous fistula stenosis, percutaneous transluminal angioplasty was performed. After successful treatment with percutaneous transluminal angioplasty, the patient developed dizziness. Magnetic resonance imaging with angiography of the brain and neck revealed normal bilateral subclavian and carotid arteries. However, flow in the left vertebral artery was not detected in time-of-flight magnetic resonance angiography. The left vertebral artery showed completely reversed blood flow as detected by color duplex ultrasound. We also confirmed anterograde flow in the left vertebral artery by color duplex ultrasound with arteriovenous fistula compression. Arteriovenous flows before the arteriovenous fistula stenosis and post-percutaneous transluminal angioplasty were 1146 and 2239 mL/min, respectively. These findings suggested high-flow arteriovenous fistula led to the subclavian steal syndrome. The patient was subsequently treated by a flow reduction in the high-flow arteriovenous access using a modified graft inclusion technique. We decreased the arteriovenous fistula flow to 851 mL/min, which remained under 850 mL/min, 1 year later. The brain natriuretic peptide level and right-ventricular pressure also decreased after treatment. A modified graft inclusion technique was successful in decreasing the high flow of the arteriovenous fistula, and improved subclavian steal syndrome symptom and cardiac overload. Conclusion: This case shows that percutaneous transluminal angioplasty for an arteriovenous fistula may induce subclavian steal syndrome, and a modified graft inclusion technique was useful in improving the high flow of an arteriovenous fistula.

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