Naslov
Bilateral Subclavian Steal Syndrome – Case report.

Autori
Budinčević, Hrvoje ; Friedrich, Latica ; Tolj- Karaula, Nikolina ; Marić, Nikolina ; Sučić, Tena ; Bielen, Ivan.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Acta Clinica Croatica 51 (Suppl 1) / - , 2012

Skup
52nd International Neuropsychiatric Pula Congress,

Mjesto i datum
Pula, Hrvatska, 20.06.2012. - 23.06.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
subclavian steal syndrome

Sažetak
Background Subclavian steal syndrome is caused by a severe stenosis or occlusion of subclavian or innominate artery, and bilateral finding is rare. Methods This case report reveals potential cause of falsely low values of arterial blood pressure unresponsive to standard vasopressor treatment. Results – Case report We report a case of a 56- year-old male patient who presented to the ER with ligtheadedness, vomiting and a sense of tingling in his right arm. His arterial blood pressure was 80/60 mmHg on both arms, and he was initially admitted to the Intensive care unit and treated with standard vasopressor agents. He also had a right-beating horizontal gaze-evoked nystagmus. There was a bruit over left carotid artery, as well as in supra- and infraclavicular region. Carotid and vertebral ultrasound showed signs of partial steal syndrome in the right CCA, with reversed flow in the right ECA and reduced flow in the right ICA . There were signs of bilateral steal syndrome in vertebral arteries. TCD pointed to reversed flow in both VA in their intracranial segment. Aortic arch angiography revealed subtotal stenosis of right innominate artery and occlusion of left subclavian artery. Our patient with blood pressure of 80/60 mmHg on both brachial arteries was later measured with 160/80 mmHg on both legs. Eventually, patient was treated by interventional radiologist who performed percutaneous transluminal angioplasty on right innominate artery. Control carotid and vertebral artery ultrasound showed only sonological signs of complete left subclavian steal syndrome. Patient received bispoprolole and perindopril because of high blood pressure. Conclusion The bilateral subclavian steal syndrome should be taken into account in case of a seemingly hypotensive patient unresponsive to standard therapy.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA