Subclavian steal syndrome: an update

Area of Science:

• Vascular Surgery
• Neurology
• Cardiovascular Medicine

Background:

• Subclavian steal syndrome (SSS) is a condition caused by narrowing or blockage of the subclavian artery.
• It can lead to reversed blood flow in the vertebral artery, potentially causing neurological symptoms.

Purpose of the Study:

• To analyze the clinical presentation, surgical management, and outcomes of patients with subclavian steal syndrome.
• To evaluate the efficacy of surgical repair for SSS and identify factors influencing outcomes.

Main Methods:

• Retrospective review of 22 patients diagnosed with subclavian steal syndrome.
• Analysis of clinical findings, surgical procedures (including carotid subclavian bypass and carotid revascularization), and patient outcomes.
• Assessment of blood pressure differentials and pulse status.

Main Results:

• The study included 22 patients (13 men, 9 women) with a mean age of 51 years, predominantly left subclavian artery obstruction.
• Most patients presented with a blood pressure differential >20 mm Hg and diminished ipsilateral pulses.
• Twenty-one patients underwent surgical repair, with carotid subclavian bypass being the most common procedure. 19 patients had good long-term results; one patient died due to tetralogy, and three experienced complications.

Conclusions:

• Symptomatic subclavian steal syndrome often requires surgical intervention, with extrathoracic bypass offering a low risk and good long-term outcomes.
• Medical management may be suitable for asymptomatic or mildly symptomatic individuals.
• Surgery is particularly indicated when significant associated carotid artery lesions are present.