• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.136-136
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• 2001

Purpose： Subclavian steal refers to the retrograde flow of blood in a vertebral artery that supplies t ipsilateral shoulder and arm caused by proximal subclavian artery stenosis or occlusion. T purpose of this exhibit is to demonstrate MR findings of subclavian steal on contrast-enhanc 3D (CE 3DMRA) and 2D TOF MR angiography. Method： Four patients(men 3 and women 1, age： 28-78years) with subclavian steal obtained both CE 3DMRA and digital subtraction angiography(DSA) including subclavian arterie Sequential imaging was undertaken during first pass after double dose of Gd-DTPA (0 mM/kg) Injected by a power injector. Coronal source images were obtained with coronal D-fast low angle shot sequence(TR/TE/flip angle=3.8/l.3/35, acquisition time= 10sec/one measurement). Precontrast imaging was subtracted from enhanced images and maximu intensity projection was done. 2D time-of-flight MR angiography(2D TOF) of the carot bifurcation was added in all cases with post-saturation. All studies were review retrospectively.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.316-321
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• 2017

The occurrence of subclavian steal syndrome is possible in patients with either severe stenosis or occlusion in the left proximal subclavian or brachiocephalic arteries. Limited and insufficient blood flow in the vessel with a lesion induces blood supply from the opposite side via any of the connected vessels, which is called a subclavian steal phenomenon. The duplex sonography is useful for detecting this phenomenon. Some patients who experience this phenomenon complain of vertebrobasilar insufficiency, such as headache or numbness and weakness in the arm, and so on. Subclavian steal syndrome means subclavian steal phenomenon accompanied by these symptoms. We present a patient with focal severe stenosis of the brachiocephalic artery, manifested as blood flow reversal in the vertebral, and a "to-and-fro" waveform pattern in the external carotid, internal carotid, and common carotid arteries.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.370-374
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• 2018

Subclavian steal syndrome is a type of obstructive artery disease caused by severe stenosis and occlusion of a left proximal subclavian artery or brachiocephalic trunk. The resulting vertebro-basilar insufficiency symptoms are due to retrograde blood flow from the contralateral vertebral and basilar arteries into the low-pressure ipsilateral upper extremity vessels. For that reason, patients usually experience dizziness or arm ischemic symptoms. Neurointervention is an effective treatment for ischemic stroke, including the subclavian artery stenosis. This paper reports a patient with subclavian steal syndrome who had a vertebral artery Doppler waveform change in duplex sonography and a 12 mmHg difference in interarm systolic blood pressure. A stenotic lesion of the subclavian artery was treated effectively by inserting a precise stent. The follow up examination showed that the vertebral artery Doppler waveform change disappeared and recovered and that the 12 mmHg difference in interarm systolic blood pressure decreased to 5 mmHg after treatment.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.415-418
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• 2015

Right aortic arch with isolation of the left subclavian artery is a rare anomaly. The incidence of bilateral ductus arteriosus is sporadic, and a right aortic arch with isolation of the left subclavian artery in association with bilateral ductus arteriosus is therefore extremely rare. Since the symptoms and signs of isolation of the left subclavian artery can include the absence or underdevelopment of the left arm, subclavian steal syndrome, or pulmonary artery steal syndrome, the proper therapeutic approach is controversial. We report a case in which surgical reconstruction was used to treat isolation of the left subclavian artery with right aortic arch in association with bilateral ductus arteriosus and a ventricular septal defect.

• Proceedings of the KSMRM Conference
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• 1999.11a
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• pp.51-51
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• 1999

• Journal of Chest Surgery
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• v.46 no.1
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• pp.84-87
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• 2013

A 60-year-old man visited the outpatient clinic due to one month of recurrent exertional chest pain. Eleven years earlier he had undergone off-pump coronary artery bypass grafting using bilateral internal thoracic artery (ITA) Y-composite grafts based on the left ITA. Preoperative coronary angiography showed patent distal graft anastomoses and visualized the left ITA retrogradely. The arch aortography revealed near-total occlusion of the left subclavian artery at the level of the ostium. The patient underwent left carotid-to-subclavian artery bypass grafting using a 6 mm vascular conduit. Postoperative computed tomographic angiography revealed a patent bypass conduit between the left common carotid artery and left subclavian artery. The patient was discharged on postoperative day 4 with no symptoms or signs of myocardial ischemia.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.159-168
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• 2012

The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.60-63
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• 1999

Transcranial Doppler(TCD) is an important diagnostic tool for evaluating the patients with stroke. It has some advantages and unique role when compared with other neuroimaging modalities. Recent development of transcranial color-coded Doppler(TCD) improves the limitation and pitfalls of TCD. The current indications of TCD are as follows: 1. Screening and evaluation of the intracranial major vessels 2. early detection and follow-up of vasospasm due to SAH 3. emboli detection (high-imtensity transient signals, HITs) 4. dignosis and follow-up of subclavian steal 5. evaluation of intracranial collaterals when the extracranial ICA has severe stenosis or occlusion 6. evaluation of cerebral perfusion pressure (intracranial pressure) 7. evaluation of arteriovenous malformation 8. diagnosis and follow-up of arterial dissenction 9. diagnosis and follow-up of venous sinus thrombosis (experimental).

• Journal of Chest Surgery
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• v.22 no.2
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• pp.330-336
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• 1989

The patient was 47-year-old male who had suffered from aphasia and hemiplegia of the right side, but mental state was alert. On physical examination, BP was 130/80 mmHg in the right arm, but not checked in the left arm. The pulses of the left common carotid, brachial, and radial arteries were not palpable. The pulses of the right femoral, popliteal, and dorsalis pedis arteries were weakly palpable. Brain CT Scan revealed cerebral infarction of the left hemisphere. Aortogram showed occlusion of the left common carotid, and the right internal carotid and common iliac arteries. Subclavian steal phenomena were observed in the delayed aortogram. Double extra-anatomic bypasses; Axillo-Axillar bypass and Femora-Femoral bypass, were performed in the local anesthesia at two stages, because of risk of major operation under general anesthesia. Postoperatively, all pulses except for pulse of the left common carotid artery were equally palpable. On discharge, the hemiplegia of the right side was improved and able to walk with assistance.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.448-453
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• 2023

Takayasu arteritis (TA) is a disease that causes inflammation and stenosis of medium to large blood vessels. We report a case of a 50-year-old female patient with newly developed hypertension, syncope, and claudication of the extremities. Total occlusion of the left subclavian artery at the origin was found and significant stenosis of the right common iliac artery was revealed by hemodynamic analysis. She was successfully treated with percutaneous angioplasty for multiple peripheral arterial diseases and was finally diagnosed with TA. In consultation with a rheumatologist, medical treatment for TA was initiated, the patient's hypertension disappeared, and her claudication symptoms improved.