title: Asymptomatic high flow subclavian steal in a patient with hemodialysis access.
abstract: BACKGROUND
  Subclavian steal phenomenon due to proximal subclavian artery stenosis or occlusion is not un-common but often remains asymptomatic.
  
  
  METHODS
  We describe the case of a 66-year-old man with end-stage renal disease hemodialysed through a brachio-brachial loop graft of the left forearm. Echo-Doppler precerebral examination showed a high reversed flow of 570 ml/min in the ipsilateral vertebral artery. After successful endovascular recanalization of the subclavian artery, access blood flow increased and vertebral flow decreased to 30 ml/min. Complete neurological examination was normal both before and after endovascular treatment.
  
  
  CONCLUSIONS
  This case demonstrates how high a subclavian steal can be without causing symptoms and how well precerbral and cerebral circulation can adapt to hemodynamic changes.
authors.affiliation: Department of Vascular Medicine, Centre Hospitalier Universitaire Vaudois, Switzerland. Cedric.Bron@chuv.ch
authors.forename: Cédric
authors.initials: C
authors.lastname: Bron
authors.forename: Lorenz
authors.initials: L
authors.lastname: Hirt
authors.forename: Georges
authors.initials: G
authors.lastname: Halabi
authors.forename: François
authors.initials: F
authors.lastname: Saucy
authors.forename: Salah D
authors.initials: SD
authors.lastname: Qanadli
authors.forename: Erik
authors.initials: E
authors.lastname: Haesler
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D002560:Cerebrovascular Circulation; D006439:Hemodynamics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D012039:Regional Blood Flow; D006435:Renal Dialysis; D013349:Subclavian Steal Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D034941:Upper Extremity / Q000098:blood supply*