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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Italian Journal of Vascular and Endovascular Surgery 2004 December;11(4):163-6
Redo in subclavian steal syndrome. A case report
La Marca G., La Barbera G., Rinaudo G., Ricevuto G., Martino A.
Vascular Surgery Unit, City Hospital, Palermo, Italy
An atypical case of subclavian steal syndrome (SSS), recently observed and treated is described. SSS is a rare but characteristic manifestation of cerebrovascular disease due to prevertebral subclavian artery occlusion. Symptomatic patients are commonly treated by surgical therapy. The most used interventions are the carotid-subclavian bypass and the subclavian-carotid transposition. Both these interventions show a good long-term patency (80-96%). The case presented is characterized by repeated failures of the surgical interventions carried out in the following time sequence: carotid-subclavian bypass, subclavian artery PTA and axillo-axillary bypass. The presence of thrombophilic states was unsuccessfully searched in order to justify repeated graft thrombosis; therefore, the authors performed a redo carotid-subclavian bypass, still patent after 1 year. The not always correct therapeutic timing is examined in order to explain the failure of the multiple surgical interventions this patient was submitted to.