engleski

Subclavian fusiform aneurysm causing partial subclavian steal syndrome (case report)

Subclavian steal syndrome (SSS) is the phenomenon of reverse blood flow in the vertebral artery (VA), which is usually caused by stenosis or occlusion of the subclavian artery (SA) proximal to the vertebral artery origin (1). We present a 55-year-old man with repeated transient symptoms of vertebrobasilar arterial pathology. For 15 years he has been treated with medication for type 2 diabetes mellitus. He was nonsmoker in the last 15 years. He had no history of hypertension, no previous injury to the head, neck, or shoulders. Physical examination detected no signs that would indicate the stenosis of the proximal subclavian artery segment. Repeated measurements of blood pressure in upper arms were normal (120/70 mmHg), with no difference between the two arms. Extracranial color Doppler found a narrow right VA (2 mm in diameter), with low flow velocities (peak systolic velocity 0.21 m/s), and hemodynamic spectrum corresponding to partial subclavian steal syndrome (PSSS) (alternating direction of circulation of the dominant antegrade flow and retrograde flow in late systole). According to a number of authors such VA waveform match stenosis SA between 55-80% (2). The left VA had normal hemodynamic spectrum. Computed tomography angiography confirmed the fusiform aneurysm of the right SA. From the center of the aneurysm the starting point of the VA was identified toghether with the V1 segment of hypoplastic VA. Ultrasound detection of PSS phenomenon can sometimes indicate an aneurysmal expansion of the subclavian artery in the VA origin area.

aneurysm ; subclavian artery ; subclavian steal syndrome

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