Subclavian steal syndrome treated by kissing stenting of the subclavian and vertebral arteries

Rebecca Zener, Jeff Jaskolka, Graham Roche-Nagle
BMJ Case Reports 2020 May 18, 13 (5)
The prevalence of subclavian artery (SA) stenosis is approximately 2%. The exact prevalence of extracranial vertebral artery (VA) stenosis is undetermined, with estimates ranging from 7% to 40%. Nearly 25% of ischaemic strokes involve the vertebrobasilar circulation, and arteriosclerotic disease and narrowing of the proximal VA may be the cause for up to one-fifth of these incidents. The bulk of SA stenoses occur proximally to the ostium of the VA. Vertebrobasilar ischaemia can be caused both by VA and SA stenosis. Surgical and endovascular approaches are potential treatment options for SA/VA stenosis. It has been demonstrated that endovascular intervention is considerably safer for this pathology, and with advances in device technology, angioplasty with stenting has become the preferred treatment option. We present the case of a 76-year-old man who presented with vertebrobasilar ischaemia from coexisting stenosis of the SA/VA which was treated by endovascular methods.

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