Bron Cédric, Hirt Lorenz, Halabi Georges, Saucy François, Qanadli Salah D, Haesler Erik
Department of Vascular Medicine, Centre Hospitalier Universitaire Vaudois, Switzerland.
J Vasc Access. 2010 Jan-Mar;11(1):63-5. doi: 10.1177/112972981001100113.
Subclavian steal phenomenon due to proximal subclavian artery stenosis or occlusion is not un-common but often remains asymptomatic.
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.
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.
由于锁骨下动脉近端狭窄或闭塞导致的锁骨下动脉窃血现象并不罕见，但通常无症状。
我们描述了一名66岁患有终末期肾病的男性患者，通过左前臂的肱-肱环行移植血管进行血液透析。经颅多普勒超声检查显示同侧椎动脉有570毫升/分钟的高反向血流。锁骨下动脉成功进行血管腔内再通术后，通路血流量增加，椎动脉血流降至30毫升/分钟。血管腔内治疗前后的全面神经学检查均正常。
该病例表明锁骨下动脉窃血程度很高时仍可不引起症状，以及经颅和脑循环对血流动力学变化的适应能力有多强。
