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The Journal of Cardiovascular Surgery 1999 April;40(2):265-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Subclavian ­steal syn­drome and ­flow-relat­ed aneu­rysm. Another rea­son to ­treat

Pasco A., Papon X. *, Fournier D. **, Mercier P. **, Caron-Poitreau C., Enon B. *

From the Unit of Neuroradiology Department of Radiology * Department of Cardiovascular and Thoracic Surgery ** Department of Neurosurgery Larrey Hospital, University of Angers, France


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A 48-­year-old wom­an pre­sent­ed ­with a symp­to­mat­ic ­right sub­cla­vian ­steal syn­drome due to prox­i­mal sub­cla­vian ­artery sten­o­sis. Anatomically the innom­i­nate ­artery was ­absent. Collateral cir­cu­la­tion fol­lowed the ver­te­bro-ver­te­bral path­way ­with rever­sal of ­blood ­flow in the ipsi­lat­er­al ver­te­bral ­artery. There was ­also mul­ti­ple dilat­ed inter­ver­te­bral col­lat­er­als and an asso­ciat­ed sac­cu­lar aneu­rysm on one of ­them. Surgical carot­id-sub­cla­vian trans­po­si­tion per­mit­ted ­relief of clin­i­cal symp­toms, dis­ap­pear­ance of col­lat­er­al cir­cu­la­tion and sub­to­tal regres­sion of the aneu­rysm. This spon­ta­ne­ous evo­lu­tion con­firmed the ­role of ­high-­flow in the path­o­gen­e­sis of ­some aneu­rysms and the habit­u­al­ly ­good prog­no­sis of ­flow-relat­ed aneu­rysms ­with cor­rec­tion of the ­cause. Arteriography ­still ­appears essen­tial in diag­no­sis, prether­a­peu­tic assess­ment and some­times ­post-treat­ment eval­u­a­tion in sub­cla­vian ­steal syn­drome.

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