Diagnosis and treatment of subclavian steal syndrome: 2 cases reports and literature review
Qu Yuan
Zhang Zhaohui
Shi Zhaokun
Chen Yang
Abstract：Objective To explore the clinical manifestations,imaging examination features,diagnosis and treatment strategies of subclavian steal syndrome (SSS).Methods The clinical data,transcranial doppler ultrasonography (TCD) manifestations and treatment process of 2 patients with SSS were retrospectively analyzed and the relevant literature were reviewed.Results Case 1,male,51 years old,hospitalization for "weakness of left upper limb for 4 h".TCD:the initial blood flow velocity of left subclavian artery was increased and early diastolic blood flow was disappeared,which suggested severe stenosis;the blood flow of left vertebral artery was completely reversed,which suggested subclavian steal 3 stage;there was a notch on the right vertebral artery systolic;Trousseau's test (+),the blood flow velocity decreased after loosening the band,which indicated right subclavian steal 1 stage.Percutaneous endovascular angioplasty was given,followed by clopidogrel (75 mg/d).Three months later,TCD showed complete left subclavian artery steal and normal artery blood flow of right vertebral artery.Case 2,male,59 years old,hosptalization for " discontinuous weakness of the right upper limb and vertigo for 4 months".TCD:bidirectional blood flow of left vertebral artery was observed,suggested steal 2 phase;the blood flow velocity and direction of right vertebral artery was normal;the flow velocity of left clavicle artery increased;Trousseau's test (+);the blood flow was reversed throughout the cardiac cycle after loosening the band,thus considering left subclavian steal with steal way of left vertebral artery to left subclavian artery.A stent was placed in the left subclavian arterty,followed by clopidogrel (300 mg of loading dose,75 mg/d of maintenance dose);3 months later,there was no recurrence.Conclusion TCD is the first choice for screening SSS;for those SSS patients with symptoms,angioplasty and stent implantation are preferred.
Keywords：Subclavian steal syndromeTranscranial color doppler ultersoundLiterature review
Publication Date：2016-09-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1311-1315 )