Extrathoracic Surgical Treatment of Subclavian Steal Syndrome

Abstract

Twelve patients with” subclavian steal syndrome” were studied in 36 months period from June 2013 to June 2016. Their age ranged between 21-55 years with a mean age of 32 years. Female sex represented (7/12, 58.33%). All cases were subjected to complete history taking and clinical examination. They presented with drowsiness and, or fainting after left upper limb exercise. This was associated with manifestations of chronic left upper limb ischemia. Investigations were done for all cases including laboratory investigations, Duplex US, Angiography and CT Angiography. Surgical treatment was done for all cases (7 cases were treated by transcervical subclavian -subclavian bypass graft, 4 cases were treated by left common carotid to left subclavian artery bypass graft and one case by right subclavian to left axillary artery bypass graft). Ringed Gortex graft 8mm was used in all cases. The results of all surgical operations were successful and the symptoms of the brain and left upper limb ischemia disappeared. The graft in one case was occluded after 2½ years due to intimal hyperplasia (the case of right subclavian to left axillary artery bypass graft). Clearance of the graft was done by using Fogarty catheter. All grafts were functioning well and the results were excellent.