Subclavian steal syndrome and flow-related aneurysm. Another reason to treat.
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.
Pasco
A
A
Department of Radiology, Larrey Hospital, University of Angers, France.
Papon
X
X
Fournier
D
D
Mercier
P
P
Caron-Poitreau
C
C
Enon
B
B
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016122:Brachiocephalic Trunk / Q000002:abnormalities; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D012039:Regional Blood Flow; D013349:Subclavian Steal Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014711:Vertebral Artery / Q000000981:diagnostic imaging