Subclavian Steal Syndrome

Chirag N. Shah, MD, FACEP and Brent M. Lewis, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Subclavian steal syndrome (SSS): a condition that results from stenosis or occlusion of the subclavian artery proximal to the origin of the vertebral artery, causing retrograde flow ...

DIAGNOSIS

  • Reduced BP of >15 mm Hg in involved arm

  • Symptoms should be reproducible by exercising the arm.

  • A variation of the syndrome is the coronary SSS, which can only occur after coronary artery by...

TREATMENT

GENERAL MEASURES

  • Antiplatelet therapy with aspirin (or clopidogrel, if intolerant of aspirin), especially in patients with concomitant coronary artery disease

  • Reduce cholesterol levels, if app...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Poststenting follow-up at 1-, 6-, and 12-month intervals initially and then yearly thereafter

  • Frequent neurologic review of systems and subclavian Doppler ultrasou...

REFERENCES

Potter BJ, Pinto DS. Subclavian steal syndrome. Circulation.  2014;129(22):2320–2323.  [View Abstract]
Mousa AY, Morkous R, Broce M, et al. Validation of subclavian duplex velocity cr...

ADDITIONAL READING

  • Aboyans V, Criqui MH, McDermott MM, et al. The vital prognosis of subclavian stenosis. J Am Coll Cardiol.  2007;49(14):1540–1545.

  • Alcocer F, David M, Goodman R, et al. A forgott...

CODES

ICD10

G45.8 Oth transient cerebral ischemic attacks and related synd 

ICD9

435.2 Subclavian steal syndrome 

SNOMED

15258001 Subclavian steal syndrome 

CLINICAL PEARLS

  • Takayasu arteritis/vasculitis is most common in young females. The aorta and its branches are the major vessels affected by inflammation, thrombus formation, and aneurysmal dilatation....

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