title: [Subclavian-carotid transposition in the treatment of obstructive subclavian disease with steal syndrome].
abstract: Eleven patients with subclavian steal syndrome underwent end-to-side transposition of the subclavian into the common carotid artery. The post-operative evaluation was done in every case by neurological examination, brachial blood pressure measurement, transcutaneous Doppler examination and by angiography. The operative result of this reconstruction, which was performed mainly on high-risk patients, was excellent. The symptoms of subclavian steal disappeared. In all but one patient the brachial pressure raised to normal. After transposition a blood flow reduction of 20% was measured intraoperatively in the peripheral common carotid artery, while the vertebral blood flow reversed to its natural direction. The peripheral common carotid artery pressure measured simultaneously remained unchanged, and hemodynamic criteria of carotis steal were not detected. The blood flow quality at the anastomosis was measured by the turbulence index in patients with an ideal reconstruction. The amount of blood flow distortion caused by the anastomosis was negligible. Therefore a long patency is expected. In patients with occlusive disease of the proximal subclavian artery we like to recommend the transposition as the procedure of choice, because the method uses one single incision for the extrathoracic exposure and one anastomosis-only without any graft material.
mesh_terms: D001157:Arterial Occlusive Diseases / Q000601:surgery; D001314:Auscultation / Q000295:instrumentation; D001807:Blood Vessel Prosthesis; D002339:Carotid Arteries / Q000637:transplantation*; D006439:Hemodynamics; D006801:Humans; D013348:Subclavian Artery / Q000637:transplantation*; D013349:Subclavian Steal Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014182:Transplantation, Autologous; D014463:Ultrasonography
vernacular_title: Subclavia-Carotis-Transposition zur Behandlung der Subclavia-Verschlusserkrankung mit Anzapfsyndrom.