A review of subclavian steal syndrome with clinical correlation

Stephen Osiro, Anna Zurada, Jerzy Gielecki, Mohammadali Mohajel Shoja, R. Shane Tubbs, Marios Loukas

Research output: Contribution to journalReview article

49 Scopus citations

Abstract

Subclavian 'steal' phenomenon is a function of the proximal subclavian artery (SA) steno-occlusive disease, with subsequent retrograde blood flow in the ipsilateral vertebral artery (VA). The symptoms from the compromised vertebrobasilar and brachial blood flows constitute the subclavian steal syndrome (SSS), and include paroxysmal vertigo, drop attacks and/or arm claudication. Once thought to be rare, the emergence of new imaging techniques has drastically improved its diagnosis and prevalence. The syndrome, however, remains characteristically asymptomatic and solely poses no serious danger to the brain. Recent studies have shown a linear correlation between increasing arm blood pressure difference with the occurrence of symptoms. Atherosclerosis of the SA remains the most common cause. Doppler ultrasound is a useful screening tool, but the diagnosis must be confirmed by CT or MR angiography. Conservative treatment is the initial best therapy for this syndrome, with surgery reserved for refractory symptomatic cases. Percutaneous angioplasty and stenting, rather than bypass grafts of the subclavian artery, is the widely favored surgical approach. Nevertheless, large, prospective, randomized, controlled trials are needed to compare the long-term patency rates between the endovascular and open surgical techniques.

Original languageEnglish (US)
JournalMedical Science Monitor
Volume18
Issue number5
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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Keywords

  • Retrograde blood flow
  • Subclavian artery stenosis
  • Subclavian steal syndrome

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Osiro, S., Zurada, A., Gielecki, J., Mohajel Shoja, M., Shane Tubbs, R., & Loukas, M. (2012). A review of subclavian steal syndrome with clinical correlation. Medical Science Monitor, 18(5). https://doi.org/10.12659/MSM.882721