Summary
Correlation of duplex sonography, angiography of the vertebral artery, and the degree of subclavian or innominate stenosis was carried out in ten patients with the subclavian steal phenomenon. Four successive stages of Doppler waveform were identified by duplex sonography. Three angiographic patterns of decreasing severity, permanent reversal, to-and-fro motion and delayed opacification, were found. Permanent reversal angiograms corresponded to complete reversal or late transient Doppler waveforms. To-and-fro motion and delayed opacification angiograms did not necessarily have a corresponding Doppler pattern. The different stages of subclavian steal phenomenon on duplex sonography correlated significantly with the degree of subclavian or innominate stenosis. Stenosis of at least 60% was found to produce abnormal vertebral artery Doppler sonography, except in one patient. Duplex sonography is considered to be a sensitive and convenient method for detecting abnormal vertebral artery haemodynamics and the subclavian steal phenomenon, but some other factors may be important in producing the Doppler waveforms.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fisher CM (1961) A new vascular syndrome: “the subclavian steal”. N Engl J Med 265: 912–913
Hennerici M, Klemm C, Rautenberg W (1988) The subclavian steal phenomenon: a common vascular disorder with rare neurologic deficits. Neurology 38: 669–673
Bornstein NM, Norris JW (1986) Subclavian steal: a harmless haemodynamic phenomenon. Lancet I: 303–305
Reutern GM von, Pourcelot L (1978) Cardiac cycle-dependent alternating flow in vertebral arteries with subclavian artery stenoses. Stroke 9: 229–236
Pourcelot L (1982) Continuous wave Doppler techniques in cerebral vasculature disturbances. In: Reneman RS, Hoeks APG (eds) Doppler ultrasound in the diagnosis of cerebrovascular disease. Research Studies Press. Chichester, pp 103–128
Ringelstein EB, Zeumer H (1984) Delayed reversal of vertebral artery blood flow following percutaneous transluminal angioplasty for subclavian steal syndrome. Neuroradiology 26: 189–198
Walker DW, Acker JD, Cole CA (1982) Subclavian steal syndrome detected with duplex pulsed Doppler sonography. AJNR 3: 615–618
Bendick PJ, Jackson VP (1986) Evaluation of vertebral arteries with duplex sonography. J Vasc Surg 3: 523–530
Hwang BS, Chang YC, Yip PK, Lin SL, Chen RC (1990) Ultrasonic techniques for subclavian steal phenomenon. J Ultrasound Med ROC 7: 81–84
Ringelstein EB (1989) Continuous-wave Doppler sonography of the extracranial brain-supplying arteries. In: Weinberger J (ed) Noninvasive imaging of cerebrovascular disease. Liss, New York, pp 27–48
Newton TH, Wylie EJ (1964) Collateral circulation associated with occlusion of the proximal subclavian and innominate arteries. Am J Roentgenol 91: 394–405
North RR, Fields WS, DeBakey ME, Crawford ES (1962) Brachial-basilar insufficiency syndrome. Neurology 12: 810–820
Schwartzwan R, Parker JC (1980) The aortic arch syndrome. In: Vinken PJ, Bruyn GW, Klawans HL (eds) Handbook of neurology, vol 39. Neurological manifestation of systemic diseases, part II. Elsevier, Amsterdam, pp 213–238
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yip, P.K., Liu, H.M., Hwang, B.S. et al. Subclavian steal phenomenon: a correlation between duplex sonographic and angiographic findings. Neuroradiology 34, 279–282 (1992). https://doi.org/10.1007/BF00588181
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00588181