What Is Subclavian Steal Syndrome?Subclavian steal syndrome is a relatively uncommon form of peripheral artery disease (PAD) in which a blockage is present in a critical location within one of the subclavian arteries, causing symptoms that involve both the arm and the brain.
The subclavian arteries are the large arteries which arise from the aorta near the base of the neck, and travel beneath the collar bones to supply blood to each arm. In the neck, each subclavian artery gives off a vertebral artery, which supplies blood to the base of the brain.
Subclavian steal syndrome can occur if there is a complete or partial blockage in the subclavian artery just prior to the take-off of the vertebral artery. When the arm supplied by the blocked subclavian artery is exercised, blood can be drawn away (i.e., "stolen") from the brain, via the vertebral artery, to supply the exercising arm. So, during arm exercise, a patient with subclavian steal syndrome can experience not only claudication of the affected arm, but also symptoms related to insufficient blood flow to the brain.
These neurological symptoms may include syncope (loss of consciousness), double vision and other visual disturbances, ringing in the ears, vertigo, or dizziness.
How Is Subclavian Syndrome Treated?Because subclavian steal syndrome is a form of PAD, it is treated the same way any PAD is treated. (Read about the treatment of PAD.) The symptoms of subclavian steal syndrome often improve with medical therapy, and invasive treatment can often be avoided. If medical therapy is ineffective, angioplasty can be very helpful in relieving symptoms of subclavian steal syndrome.
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Smith, JM, Koury, HI, Hafner, CD, Welling, RE. Subclavian steal syndrome. A review of 59 consecutive cases. J Cardiovasc Surg (Torino) 1994; 35:11.