[Evaluation of neurosonography for a case of brainstem transient ischemic attack (TIA) due to proximal subclavian artery stenosis, with favorable outcome after axillo-axillary bypass grafting].
We report an 82-year-old man with crescendo brainstem TIA and left upper-limb ischemia due to the left proximal subclavian artery stenosis. Angiography revealed that the left proximal subclavian artery was stenotic. The right vertebral artery was considered to be aplastic or occlusive. Neurosonography, especially the echo-Doppler study of the left vertebral artery, showed that the subclavian artery steal phenomenon did not occur. This study has enabled us to opt for axillo-axillary bypass. We preferred to avoid percutaneous transluminal angioplasty in order to avoid the risk of embolization. The patient received the axillo-axillary bypass operation. He has been free of TIAs and the left upper-limb ischemia since the surgery. We have evaluated his blood circulation fully, by comparing his state before and after the axillo-axillary bypass grafting.
Matsuda
Nozomu
N
Department of Neurology, Fukushima Medical University.
Matsuura
Yutaka
Y
Soeta
Tomoko
T
Shibano
Ken
K
Endo
Kazuhiro
K
Sato
Yoshiyuki
Y
Takahashi
Koki
K
Yokoyama
Hitoshi
H
Yamamoto
Teiji
T
D000368:Aged; D000369:Aged, 80 and over; D001366:Axillary Artery / Q000601:surgery*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000601:surgery*; D008297:Male; D013349:Subclavian Steal Syndrome / Q000150:complications / Q000601:surgery*; D014463:Ultrasonography; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D014656:Vascular Surgical Procedures / Q000379:methods; D014711:Vertebral Artery / Q000000981:diagnostic imaging