The subclavian-vertebral artery steal syndrome (SSS) is the hemodynamic phenomenon of blood flow reversal in the vertebral artery due to significant stenosis or occlusion of the proximal subclavian artery or the innominate artery. Occasionally, SSS is diagnosed in patients not harboring arterial stenosis. With the exception of arterial congenital malformations, the limited case reports of SSS with intact subclavian artery are attributed to dialysis arteriovenous fistulas (AVFs). Interestingly, these cases are more frequently symptomatic than those with the classical atherosclerotic SSS forms. On the other hand, the disclosure of SSS due to subclavian/innominate artery atherosclerotic stenosis, even in the absence of accompanying symptoms, should prompt a thorough cardiovascular work-up for the early detection of coexisting coronary, carotid, or peripheral artery disease. Herein, we review the incidence, clinical presentation, sonographic findings, and therapeutic interventions related to SSS with and without subclavian/innominate artery stenosis. We also review the currently available data in the literature regarding the association of SSS and dialysis AVF. In addition, we present a patient with bilateral symptomatic SSS as the result of an arteriovenous graft (AVG) that was introduced after the preexisting AVF in the contralateral arm became nonfunctional. SSS due to subclavian or innominate artery stenosis/occlusion is rarely symptomatic warranting interventional treatment. In contrast, when it is attributed to AVF, surgical correction is frequently necessary.
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http://dx.doi.org/10.1111/jon.12371 | DOI Listing |
J Ultrasound
January 2025
Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
Introduction: Post-stroke cognitive impairment (PSCI) and dementia affect short- and long-term outcome after stroke and can persist even after recover from a physical handicap. The process underlying PSCI is not yet fully understood. Transcranial Doppler ultrasound (TCD) is a feasible method to investigate cerebrovascular aging or dementia, through the pulsatility index (PI), the cerebrovascular reactivity (e.
View Article and Find Full Text PDFJ Hand Surg Am
January 2025
The Ottawa Hospital, Ottawa, ON, Canada; Division of Orthopaedic Surgery, The Ottawa Hospital Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. Electronic address:
Purpose: We compared the radiographic union and magnitude of humpback deformity correction when using different vascularized bone grafts (VBGs) and nonvascularized bone grafts (NVBGs) in the treatment of unstable scaphoid nonunions (USNUs).
Methods: This was a retrospective radiographic review of 93 patients with an USNU treated between 2013 and 2022 at a single center by a single surgeon. Inclusion criteria included skeletally mature patients with radiographic evidence of an USNU resulting from failure of either nonsurgical or operative treatment.
Port J Card Thorac Vasc Surg
January 2025
Angiology and Vascular Surgery, Unidade Local de Saúde de São João; Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal.
A 44 year-old previously healthy woman presented a persistent epigastric pain. Computed tomography revealed a saccular aneurysm with a diameter of 25x20 mm in the first jejunal artery and also a stenosis in the celiac trunk associated with median arcuate ligament syndrome, turning the hepatic perfusion dependent of the gastroduodenal artery flow. Through a midline laparotomy, celiac axis was exposed, and median arcuate ligament released for median arcuate ligament syndrome treatment.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto; RISE@Health, Porto, Portugal.
Background: Aortoiliac disease (AID) is a variant of peripheral artery disease involving the infrarenal aorta and iliac arteries. Similar to other arterial diseases, aortoiliac disease obstructs blood flow through narrowed lumens or by embolization of plaques. AID, when symptomatic, may present with a triad of claudication, impotence, and absence of femoral pulses, a triad also referred as Leriche Syndrome (LS).
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture.
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