Iatrogenic steal syndromes.

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Vascular Medicine

Background:

• Vascular steal syndromes are often caused by arteriosclerotic occlusive disease affecting major vessels like the innominate and subclavian arteries.
• Iatrogenic causes can also lead to unusual steal syndromes, impacting various vascular beds.
• These syndromes manifest with a wide range of symptoms, from neurological deficits to gastrointestinal and limb ischemia.

Purpose of the Study:

• To review the causes and clinical presentations of vascular steal syndromes, including iatrogenic origins.
• To highlight the diagnostic challenges and the importance of timely intervention.
• To emphasize the potential for severe morbidity and mortality if left untreated.

Main Methods:

• Retrospective review of patients diagnosed with vascular steal syndromes.
• Analysis of clinical presentations, underlying causes (arteriosclerotic and iatrogenic), and diagnostic methods.
• Angiography was utilized as a key diagnostic tool where necessary.

Main Results:

• Identified common causes including arteriosclerotic disease of innominate and subclavian vessels.
• Documented unusual iatrogenic steal syndromes affecting the vertebral artery, circle of Willis, colon, small bowel, and arteriovenous access for dialysis.
• Observed diverse symptoms such as dizziness, headache, bloody diarrhea, paraplegia, pain, and coma.

Conclusions:

• Recognition of the possibility of vascular steal syndromes is paramount for diagnosis.
• Angiography is essential for confirming the diagnosis.
• Prompt diagnosis and appropriate intervention, including medical and surgical options, are critical to improve outcomes and prevent severe complications like paraplegia or death.