Yuan-Yuan Sun, Guo-Ming Zhang, You-Bin Zhang, Xin Du, Mao-Long Su
BACKGROUND: We report a rare case of numbness in the right hand, finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases. CASE SUMMARY: The patient was a 65-year-old woman. She complained of dizziness, numbness and weakness of the right hand for 6 mo. She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound, enhanced computed tomography, computed tomography angiography and other examinations...
November 6, 2019: World Journal of Clinical Cases
Rin Shimozato, Mototaka Hayashi, Yukihiro Hidaka, Hidesato Takezawa, Akira Iijima
We herein report a case of direct carotid-cavernous fistula(direct CCF)in a patient with masked hypertension caused by bilateral subclavian artery stenosis. A 74-year-old woman presented with headache, right-sided proptosis, double vision, and pulsatile tinnitus since past 10 days. The patient was diagnosed with direct CCF. Transarterial embolization in the region of the right internal carotid artery was performed, after which her symptoms resolved. However, additional interventions in the form of subclavian artery stenting were required, because of the complications of left subclavian artery occlusion and right subclavian artery stenosis...
October 2019: No Shinkei Geka. Neurological Surgery
Narek Veranyan, Joie Dunn, Michael Bowdish, Gregory A Magee, Fred A Weaver, Fernando Fleischman, Sukgu M Han
Left subclavian artery revascularization during endovascular repair of aortic dissection is often accomplished by left carotid-subclavian artery bypass or transposition. In-situ fenestration of thoracic stent grafts provides an alternative method of revascularization without manipulation of the left carotid artery. We describe a case whereby in-situ laser fenestration, combined with catheter-directed thrombectomy was utilized to revascularize a thrombosed left subclavian artery following a frozen elephant trunk repair of type A aortic dissection...
October 14, 2019: Annals of Vascular Surgery
Benjamin K Hendricks, Robert F Spetzler
Vertebral artery (V1 segment) transposition is a useful technique in the treatment of patients with either proximal subclavian artery stenosis with vertebral "steal" syndrome or severe vertebral artery origin stenosis. This patient required extracranial augmentation of right vertebral artery blood flow to treat proximal vertebral artery stenosis. This was achieved through a V1 to common carotid artery end-to-side anastomosis. The end-to-side anastomosis was performed with the first stitch after the heel stich placed to the inside of the vessel, and the back wall was run from the inside...
November 1, 2019: Operative Neurosurgery (Hagerstown, Md.)
Ming Ren Toh, Deanna Lee, Karthikeyan Damodharan, Mohammad Arif Abdullah
BACKGROUND Subclavian stenosis is an uncommon clinical condition associated with severe cardiovascular complications, usually presenting with claudication and subclavian steal syndrome. Here we describe the rare case of bilateral subclavian artery stenosis in an asymptomatic patient. CASE REPORT Our patient was a 63-year-old chronic smoker with no prior medical history whose chief complaint was dyspnea from an exacerbation of his chronic obstructive pulmonary disease (COPD). He was hypotensive with blood pressure 74/56 mmHg at admission, which raised suspicion for sepsis, adrenal insufficiency but the workup (renal panel, full blood count and synacthen tests) were normal...
October 14, 2019: American Journal of Case Reports
David J Krasucki
A patient presented for elective shoulder arthroscopy who had subclavian steal syndrome. The patient's history included bilateral mastectomy with unilateral lymph node dissection, limiting noninvasive oscillometric blood pressure monitoring on the nonoperative side. This history, combined with the necessary surgical positioning and calf blood pressure monitoring, raised the concern of decreased cerebral perfusion during a general anesthetic in the beach chair position. This report describes the management of this particular case, then reviews the relevant literature regarding cardiovascular and cerebral perfusion monitoring...
June 2019: AANA Journal
Gregory Glauser, Robert W Hurst, Bryan A Pukenas, Neda I Sedora-Roman, David Kung, Omar Choudhri
BACKGROUND: Subclavian steal phenomenon can cause retrograde flow in the vertebral artery as a result of ipsilateral occlusion of the subclavian artery. This phenomenon has various clinical presentations, such as claudication of the affected extremity or intermittent vertebrobasilar ischemia. Aneurysm formation in the spinal cord circulation is exceptionally rare but may occur secondary to collateral formation in subclavian steal syndrome. CASE DESCRIPTION: The case presented herein is a 53-year-old male, who presented with headache and severe neck pain...
September 28, 2019: World Neurosurgery
Takako Iino, Takayuki Yamanaka, Wakana Sato, Kenji Iino, Hiroyuki Watanabe
Coronary subclavian steal syndrome (CSSS) is a coronary steal phenomenon secondary to subclavian artery stenosis in patients who have undergone coronary bypass surgery with the internal thoracic artery. Most commonly, CSSS is diagnosed angiographically. Our case emphasizes that stress ultrasound assessment using reactive hyperemia in the ipsilateral arm elicits a functional diagnosis of CSSS.
October 1, 2019: Echocardiography
Fang Xu, Feng Wang, Yong-Sheng Liu
BACKGROUND: As the population ages and people's living standards gradually improve, the incidence of cerebrovascular disease in China is increasing annually, posing a serious threat to people's health. The incidence of brachiocephalic artery stenosis in ischemic cerebrovascular disease is relatively low, accounting for 0.5% to 2% of patients, but its consequences are very serious. Herein, we report a case of brachiocephalic artery stenting through the carotid artery. CASE SUMMARY: The patient was a 66-year-old man...
September 6, 2019: World Journal of Clinical Cases
Asish R Mohakud, Sreeja Pavithran, Kothandam Sivakumar
Isolated subclavian artery is a rare anomaly. A second steal due to a patent arterial duct further reduces arm perfusion. Surgical anastomosis of the isolated vessel to aorta normalises arm perfusion. Simple echocardiographic clues aid in the diagnosis. An associated moderate sized ventricular septal defect was non-surgically closed along with catheter closure of the duct resulting in improved arm perfusion.
September 10, 2019: Cardiology in the Young
Manish Amin, Krishan Chaddha, Phillip Aguìñiga-Navarrete, Sudha Challa, Madison B Garrett
Cranial vascular malformations can cause symptoms of headache, stroke, transient ischemic attack, or other cerebrovascular disorders due to steal phenomenon. Subclavian steal phenomenon is a localized change in cerebral perfusion from a cranial arteriovenous malformation (AVM). We present the only recorded case of a tonsillar AVM causing a transient ischemic attack due to steal phenomenon.
August 2019: Clinical Practice and Cases in Emergency Medicine
Alireza Dehghan, Sara Haseli, Pedram Keshavarz, Marzieh Ahmadi, Pooyan Dehghani
The subclavian steal syndrome (SSS), also called subclavian steal steno-occlusive disease, is defined as reversal of the vertebral artery flow secondary to significant hemodynamically ipsilateral occlusion or stenosis of the proximal subclavian artery. It is usually seen secondary to atherosclerosis and aberrant right subclavian artery (ARSA), resulting in SSS which is even less common. Aberrant right subclavian artery is a kind of vascular anomaly associated with coarctation of the aorta (CoA). It usually originates from the descending aorta distal to the site of CoA...
July 16, 2019: Vascular and Endovascular Surgery
A A Cantador, D E D Siqueira, A T Guillaumon
Congenital Aortic Arch Anomalies are rare and may be associated with other congenital cardiovascular malformations. The authors report a rare case of anomaly in the aortic arch embryogenesis, presenting with a right aortic arch and an isolated innominate artery, associated with the subclavian steal phenomenon. This condition is discussed considering the Edwards hypothetical double embryonic arch and its clinical aspects.
June 11, 2019: Annals of Vascular Surgery
Frederic De Roeck, Maxime Tijskens, Vincent F M Segers
Coronary-subclavian steal syndrome (CSSS) is a severe complication of coronary artery bypass graft (CABG) surgery with internal mammary artery grafting. It is caused by functional graft failure due to a hemodynamically significant proximal subclavian artery stenosis. In this manuscript, we provide a comprehensive review of literature and we report a series of five consecutive CSSS cases. This case series illustrates the variable clinical presentation, thereby emphasizing the importance of raised awareness concerning this pathology in CABG patients...
June 9, 2019: Catheterization and Cardiovascular Interventions
Elaheh Malakan Rad, Hamid Reza Pouraliakbar
Isolation of the left brachiocephalic artery (ILBA) is an extremely rare anomaly of aortic arch with diverse manifestations in the neurologic system, heart, and left upper arm. This anomaly is defined as the absence of connection of the left brachiocephalic artery (LBA) to aortic arch and connection of LBA to pulmonary artery (PA) through a patent arterial duct (PAD). However, this definition is not inclusive of all cases. Not only are there inconsistencies in the definition and terminology of this aortic arch anomaly but also there is no classification for this anomaly despite its heterogeneous nature in terms of anatomy, clinical presentation and prognosis...
May 2019: Annals of Pediatric Cardiology
Weichang Zhang, Xin Li, Wenwu Cai, Ming Li, Jian Qiu, Chang Shu
PURPOSE: To evaluate the early and midterm outcomes of endovascular repair of Stanford type B aortic dissection (TBAD) with an aberrant right subclavian artery (ARSA). MATERIALS AND METHODS: From November 2012 to July 2018, 15 patients (13 male, 2 female) who had TBAD with ARSA underwent total endovascular repair, including thoracic endovascular aortic repair (TEVAR), left subclavian artery (LSA) chimney technique, LSA fenestration technique, and double chimney technique (LSA chimney and ARSA periscope)...
May 24, 2019: Journal of Vascular and Interventional Radiology: JVIR
Tracy J Cheun, Lalithapriya Jayakumar, Matthew J Sideman, Lori L Pounds, Mark G Davies
BACKGROUND: Critical hand ischemia owing to vascular access-induced steal syndrome (VASS) continues to be a significant problem. The aim of this study was to examine the outcomes of arterial endovascular interventions in the upper extremity of patients presenting with VASS. METHODS: A database of patients presenting with documented VASS between 2006 and 2016 was retrospectively queried. Patients who underwent isolated endovascular intervention in the upper extremity were analyzed...
May 21, 2019: Journal of Vascular Surgery
Xiao-Qing Cai, Feng Tian, Shan-Shan Zhou, Jing Jing, Wei Hu, Tao Zhang, Xi Wang, Ri-Na Du, Qiang Xu, Yun-Dai Chen
No abstract text is available yet for this article.
April 2019: Journal of Geriatric Cardiology: JGC
Amit R Rawal, Collin Bufano, Omar Saeed, Asif A Khan
Double steal phenomenon is a rare condition where occlusion of the innominate (brachiocephalic) artery leads to hemodynamic changes in which blood flow is shunted from the intracranial circulation down the right vertebral artery and subsequently up the right carotid and subclavian circulation. This is a case of a 67-year-old female presenting emergently with recurrent transient ischemic attacks due to double steal phenomenon. Emergency department recognition of the double steal phenomenon and large vessel occlusion by computed tomography angiogram of the head and neck allowed for early treatment, which was critical in avoiding irreversible cerebral infarction...
May 2019: Clinical Practice and Cases in Emergency Medicine
Kohei Sumi, Shigehiko Yoshida, Yoshitaka Okamura, Hideki Kunimoto
Patients with severely calcified aorta are at high risk of embolic stroke during surgery and it is not feasible to clamp the aorta, necessitating alternative surgical strategies. We present a clampless anastomosis technique using the aortic cannula mounted by a prosthetic graft for a severely calcified aorta in a patient with subclavian-vertebral artery steal syndrome.
April 21, 2019: European Journal of Cardio-thoracic Surgery
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