Document Detail

Subclavian steal syndrome: can the blood pressure difference between arms predict the severity of steal?
MedLine Citation:
PMID:  11977907     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: A side-to-side difference in systolic brachial arterial blood pressure is a common finding in subclavian artery stenosis and is frequently used as a screening tool for subclavian steal syndrome (SSS). It was the goal of this retrospective study to investigate the relationship between different vertebral artery waveform types and the side-to-side difference in systolic blood pressure in patients with sonographically proven SSS. METHODS: The records of 1860 patients from the Neuroultrasound Laboratory between January 2000 and December 2000 were screened for the diagnosis of SSS in the final ultrasound report. In all patients, bilateral brachial arterial blood pressure was measured in a sitting position prior to the ultrasound examination. Vertebral artery waveforms were classified as (1) systolic deceleration, (2) alternating flow, and (3) complete reversal at rest. Blood pressure difference as calculated by normal-side blood pressure minus lesion-side blood pressure was compared with the 3 Doppler waveform types. RESULTS: SSS was found in 51 of 1860 (2.7%) ultrasonography studies of 49 patients (17 men, 32 women; mean age 65.3 +/- 10.5 years). Two patients (4%) had bilateral SSS. In 3 patients (6%), SSS was related to an innominate artery stenosis. Waveform analysis showed a completely reversed flow in 16 (31%), an alternating flow in 24 (47%), and a systolic deceleration in 11 (22%) cases. Systolic blood pressure difference was significantly higher in the complete reversal and alternating groups than in the systolic deceleration group (P < .001). CONCLUSION: Brachial systolic blood pressure difference is related to the severity of SSS and can be used as a screening tool for SSS. However, it performed better in severe steal than milder steal phenomena.
Teng-Yeow Tan; Ulf Schminke; Li-Ming Lien; Charles H Tegeler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  12     ISSN:  1051-2284     ISO Abbreviation:  J Neuroimaging     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-29     Completed Date:  2002-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-5     Citation Subset:  IM    
Department of Neurology (I), Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
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MeSH Terms
Analysis of Variance
Arm / blood supply
Blood Flow Velocity / physiology
Blood Pressure / physiology*
Retrospective Studies
Risk Factors
Subclavian Steal Syndrome / physiopathology*,  ultrasonography*
Ultrasonography, Doppler
Vertebral Artery / physiopathology,  ultrasonography

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