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.

scholarly journals Carotid-subclavian Bypass for Subclavian Artery Occlusion associated with Subclavian Steal Syndrome

2008 ◽  
Vol 17 (8) ◽  
pp. 627-632
Author(s):  
Kohei Chida ◽  
Kuniaki Ogasawara ◽  
Masakazu Kobayashi ◽  
Yasunori Suga ◽  
Kenji Yoshida ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Artery Occlusion ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Subclavian Artery Occlusion ◽  
Steal Syndrome

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.

Axillo-axillary bypass with polytetrafluoroethylene graft for coronary subclavian steal syndrome

Vascular ◽  
2012 ◽  
Vol 20 (4) ◽  
pp. 188-192 ◽  
Author(s):  
Li Po Song ◽  
Jian Zhang
Keyword(s):  
Subclavian Artery ◽  
Artery Occlusion ◽  
Subclavian Steal Syndrome ◽  
Cardiac Complications ◽  
Ptfe Graft ◽  
Subclavian Steal ◽  
Subclavian Artery Occlusion ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

The purpose of this study is to report the results of axillo-axillary bypass (AAB) for coronary subclavian steal syndrome due to proximal subclavian artery occlusion. From 2003 to 2010, AAB using a polytetrafluoroethylene (PTFE) graft was performed in 11 patients with coronary subclavian steal syndrome. There was no perioperative mortality, stroke or cardiac complications. Over a mean follow-up of 36 months (range: 6–81 months), all bypass grafts have remained patent. No patient developed recurrent symptoms of myocardial ischemia. One patient died from hemorrhagic stroke at 31 months. Our results showed that AAB using a PTFE graft provides an effective and durable treatment option for coronary subclavian steal syndrome when attempted endovascular therapy of the occluded proximal subclavian artery is unsuccessful.

Subclavian steal syndrome without Stenosis: A Case Report and Review of the Literature

2020 ◽  
Author(s):  
Zhe Lou ◽  
Youhe Jin ◽  
Jun Yang ◽  
Chunyan Ma ◽  
Qiaobei Li ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Subclavian Artery ◽  
Artery Aneurysm ◽  
Artery Stenosis ◽  
Subclavian Steal Syndrome ◽  
Subclavian Artery Stenosis ◽  
Subclavian Steal ◽  
The Right ◽  
Steal Syndrome

Abstract Background："Stealing" of the subclavian artery is a phenomenon where proximal subclavian artery stenosis or occlusion causes retrograde blood flow in the ipsilateral vertebral artery. This, combined with ischemic symptoms of vertebrobasilar arteries or ipsilateral upper limb artery, is called subclavian steal syndrome. Sometimes, subclavian steal syndrome can occur in patients without subclavian artery stenosis, such as in patients with high-flow arteriovenous dialysis fistulas or subclavian artery aneurysms. Interestingly, compared with classic atherosclerotic subclavian steal syndrome, the former patient is more prone to symptoms like paroxysmal vertigo, drop attacks, diplopia, and arm claudication. Case Presentation ： In our case, we present a 35-year-old male who suffered from paroxysmal vertigo. Clinical physical examination did not reveal any substantial evidence of proximal subclavian artery stenosis. Transcranial Doppler and ultrasonography revealed an abnormal blood flow pattern in the right vertebral artery, consistent with partial subclavian steal syndrome. Ultrasonography and computed tomography angiography showed no stenosis in the right subclavian artery and three aneurysms in the proximal segment. The hypoplastic vertebral artery originated from the third aneurysm. Conclusions ： There are few reports of subclavian steal syndrome caused by subclavian aneurysms in the literature; our case is the first to report partial subclavian steal syndrome caused by multiple aneurysms. Following a literature review, combined with our analysis of this case, we suggest that subclavian artery aneurysm which induced subclavian steal syndrome is an often unnoticed cause of vertigo.

Sign in / Sign up

Export Citation Format

Share Document