The recognition and endovascular treatment of subclavian steal syndrome

Abstract

To investigate and evaluate the effectiveness and safety of the percutaneous transluminal angioplasty (PTA) and stent placement (SP) in the treatment of left subclavian steal syndrome (SSS). From January 2007 to December 2009, 32 patients with left SSS were selected and the digital subtracted angiography (DSA) were used to evaluate before PTA and SP. Anticoagulation and antiplatelet therapy before and after interventional treatment were taken. Then the therapeutic effect was evaluated after the procedure immediately, in the third month and the sixth month post-operatively by transcranial doppler sonography (TCD). DSA was used to evaluate therapeutic effect after PTA and SP, the stenosis degree in average lumens diameter of the patients descended from 87.5% to 15.0%. The stenosis of subclavian steal artery was obviously improved and the contraflow of vertebral artery was disappeared without the stent's recovery and displacement by TCD. The mean systolic blood pressure difference between left and right upper limb was obvious lower than that before therapy [51.6 mmHg (1 mmHg = 0.133 kPa) vs 10 mmHg after 3 months]. No embolism and death was found. PTA and SP are effective in the treatment of SSS. Anticoagulation and antiplatelet therapy after interventional treatment has a good therapeutic effect. TCD is a cheap, sensitive and non-invasive method for evaluating SSS.