Subclavian steal syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Subclavian steal syndrome
Synonyms	Subclavian steal phenomenon
Pronounce	N/A
Specialty	N/A
Symptoms	Dizziness, syncope, arm pain, neurological deficits
Complications	Stroke, transient ischemic attack
Onset	Usually adulthood
Duration	Chronic
Types	N/A
Causes	Atherosclerosis, arteritis, congenital
Risks	Smoking, hypertension, hyperlipidemia
Diagnosis	Doppler ultrasound, angiography, magnetic resonance imaging
Differential diagnosis	Cervical spondylosis, multiple sclerosis, peripheral artery disease
Prevention	N/A
Treatment	Lifestyle modification, angioplasty, surgical bypass
Medication	N/A
Prognosis	Generally good with treatment
Frequency	Rare
Deaths	N/A

Subclavian Steal Syndrome

Anatomical diagram showing the subclavian artery, relevant in Subclavian Steal Syndrome.

Subclavian Steal Syndrome is an uncommon neurovascular condition characterized by a reversal of blood flow in the vertebral artery or the subclavian artery, often observed with exertion of the upper extremity. This syndrome arises due to a stenosis or occlusion of the subclavian artery proximal to the origin of the vertebral artery.

Pathophysiology

The condition occurs when there is a significant stenosis or blockage in the subclavian artery. This results in a "steal" of blood from the vertebral artery to compensate for the reduced blood flow to the arm, leading to various neurological symptoms.

Symptoms

Symptoms of Subclavian Steal Syndrome may include:

• Dizziness or vertigo
• Syncope (fainting)
• Arm claudication (pain with exercise)
• Differences in blood pressure between arms

Diagnosis

Diagnosis typically involves:

• Clinical examination noting blood pressure differences
• Doppler ultrasound of the subclavian and vertebral arteries
• Angiography or Magnetic Resonance Angiography (MRA)

Treatment

Treatment options vary depending on the severity of symptoms and may include:

• Medical management with antiplatelet or antihypertensive medications
• Surgical intervention like bypass grafting or angioplasty

External Links

• Mayo Clinic: Subclavian Steal Syndrome
• Society for Vascular Surgery: Subclavian Steal Syndrome

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