The subclavian steal syndrome is a condition that occurs when occlusion or severe stenosis in the area of the subclavian artery. Because of the violation of the pressure of the blood in this vessel flows into the arm.
The disease involves a complex of symptoms that appear when a violation of blood flow in the spine.
The main reason for occlusion is atherosclerosis, which can have a variety of reasons, but most often it is of two types. It is non-specific or specific form, develops on the background of syphilis. Other causes include arteritis, extravascular or vascular malformations, which often are cervical rib syndrome, anterior scalene muscle, displacement of the orifices of the arteries.
As a result, the flow of blood that comes to the brain is reduced, in the best case will cause a violation of consciousness, and at worst will cause a transient ischemic attack.
The syndrome of vertebral-subclavian steal can occur in the setting of bypass surgery, resulting in the development of myocardial ischemia.
Do not think that this syndrome develops only in certain situations. Often, this diagnosis is made people with other pathologies, however, have seen the blood current in the opposite direction.
It happens in marked narrowing or occlusion of the main arterial trunk. The result is a complete overhaul of the bloodstream. And narrow vessels often due to the presence of the walls of the lipid entities of cholesterol plaques. This may narrow the lumen of the vessel by 80%, and in some cases even block it.
How does
Symptoms of subclavian artery can be very different. They are both pronounced and subtle. And it all depends on exactly how broken the bloodstream and how pronounced these changes are.
Symptoms can appear one at a time, and can grow quite quickly and all at once.
These include symptoms such as:
- Transient ischemic attack. She appears in one third of patients with this diagnosis.
- Ischemia of the upper extremities is observed in more than half of all cases.
- Dizziness.
- Neurological deficit.
- Blurred vision.
- Muscle weakness in the arm or leg on the affected side.
- The lack or barely palpable pulse on the limb, which is involved in the pathological process.
- The difference in blood pressure on the right and on the left hand can be more than 20 mm Hg.
You should know that approximately 20% of patients who will be diagnosed with steal syndrome the subclavian artery did not have any complaints and did not consider themselves sick.
Require special attention vertebrobasilar insufficiency, which is expressed in vertigo, headache, instability while walking. This occurs when there is a robbing of blood flow to the brain and instead the blood begins to flow into the right or left hand.
The second common symptom of subclavian syndrome – ischemia of the upper limb. In this case, there are 4 stages. The first marked symptoms such as increased sensitivity to cold, sensitivity to cold, paresthesia.
In the second stage, during exercise, pain, numbness, fatigue. At the third stage, pain at complete rest. Starts wasting muscle tissue. On stage 4 ulcers, swelling, blueness of extremities, necrosis, which can develop into gangrene.
It is separately necessary to tell about such a condition as pain with standing subclavian catheter. This artery is most often used for intra-arterial administration of drugs. However, the installed catheter requires proper care, and after a certain period of time, it must be replaced.
Treatment
Steal syndrome the subclavian artery is most often treated with surgery. Angiosurgery offers several standard options surgical intervention, but the choice always remains with the attending physician.
It could be implantation in the carotid artery. Not used shunt materials. Is carotid-subclavian bypass grafting, which is quite common and does not cause difficulties in the performance. But it is necessary to use a plastic material.
With the defeat of the common carotid artery is cross shunting.
Syndrome the subclavian artery is treated only surgically. Even if the patient has no visible symptoms, it is still a surgical intervention, as conservative therapy is absolutely powerless.
This is because while doctors can’t learn to accurately forecast what will happen with the limb that receives such a large amount of blood. But the blood destined for the brain.
Syndrome of compression of the subclavian artery is often diagnosed with other lesions of blood vessels, such as heart or feet.
