Tan Teng-Yeow, Schminke Ulf, Lien Li-Ming, Tegeler Charles H
Department of Neurology (I), Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
J Neuroimaging. 2002 Apr;12(2):131-5. doi: 10.1111/j.1552-6569.2002.tb00109.x.
A side-to-side difference in systolic brachial arterial blood pressure is a common finding in subclavian artery stenosis and is frequently used as a screening tool for subclavian steal syndrome (SSS). It was the goal of this retrospective study to investigate the relationship between different vertebral artery waveform types and the side-to-side difference in systolic blood pressure in patients with sonographically proven SSS.
The records of 1860 patients from the Neuroultrasound Laboratory between January 2000 and December 2000 were screened for the diagnosis of SSS in the final ultrasound report. In all patients, bilateral brachial arterial blood pressure was measured in a sitting position prior to the ultrasound examination. Vertebral artery waveforms were classified as (1) systolic deceleration, (2) alternating flow, and (3) complete reversal at rest. Blood pressure difference as calculated by normal-side blood pressure minus lesion-side blood pressure was compared with the 3 Doppler waveform types.
SSS was found in 51 of 1860 (2.7%) ultrasonography studies of 49 patients (17 men, 32 women; mean age 65.3 +/- 10.5 years). Two patients (4%) had bilateral SSS. In 3 patients (6%), SSS was related to an innominate artery stenosis. Waveform analysis showed a completely reversed flow in 16 (31%), an alternating flow in 24 (47%), and a systolic deceleration in 11 (22%) cases. Systolic blood pressure difference was significantly higher in the complete reversal and alternating groups than in the systolic deceleration group (P < .001).
Brachial systolic blood pressure difference is related to the severity of SSS and can be used as a screening tool for SSS. However, it performed better in severe steal than milder steal phenomena.
肱动脉收缩压的左右差异是锁骨下动脉狭窄的常见表现，常用于锁骨下动脉窃血综合征（SSS）的筛查。本回顾性研究旨在探讨经超声证实的SSS患者不同椎动脉波形类型与收缩压左右差异之间的关系。
对2000年1月至2000年12月神经超声实验室1860例患者的记录进行筛查，以确定最终超声报告中是否诊断为SSS。所有患者在超声检查前坐位测量双侧肱动脉血压。椎动脉波形分为：（1）收缩期减速；（2）血流交替；（3）静息时完全反向。将正常侧血压减去病变侧血压计算出的血压差值与3种多普勒波形类型进行比较。
1860例超声检查中有51例（2.7%）发现SSS，涉及49例患者（17例男性，32例女性；平均年龄65.3±10.5岁）。2例患者（4%）为双侧SSS。3例患者（6%）的SSS与无名动脉狭窄有关。波形分析显示，16例（31%）为完全反向血流，24例（47%）为血流交替，11例（22%）为收缩期减速。完全反向组和血流交替组的收缩压差值显著高于收缩期减速组（P<0.001）。
肱动脉收缩压差值与SSS的严重程度相关，可作为SSS的筛查工具。然而，在严重窃血时其表现优于轻度窃血现象。
