Zhang Zhao, Luo Anling, Yang Yujia, Li Xuzi, Deng Yiting, He Li, Zhou Muke
Department of Neurology, West China Hospital, Sichuan University.
J Atheroscler Thromb. 2025 Mar 1;32(3):385-393. doi: 10.5551/jat.65036. Epub 2024 Oct 5.
It is uncertain if there is a connection between subclavian steal phenomenon (SSP) and atherosclerotic stenosis in the opposite vertebral artery (VA). We aimed to explore the association between SSP and the incidence of contralateral vertebral artery stenosis (VAS) in vivo.
In this prospective registry study, we included patients diagnosed with ＞50% stenosis of proximal subclavian artery (SA) or innominate artery (INA) by digital subtraction angiography (DSA) from our comprehensive stroke center between 2011 and 2022. VAS and SSP was diagnosed by DSA in the resting state. Propensity score matching (PSM) was conducted among all participants and subgroups with a 1:1 ratio according to the presence of SSP. We further conducted sensitivity analysis by dividing all participants into subgroups according to the degree of stenosis and type of SSP. Binomial logistic regression analysis was applied to investigate the association of SSP with contralateral VAS.
A total of 774 patients were included in this study and 309 (39.9%) were found with SSP. After PSM, presence of SSP was associated with lower prevalence of contralateral VAS among all participants (OR 0.45; 95% CI 0.31-0.65; p＜0.001). In subgroup analysis, the association was respectively found within left subclavian (LSA) stenosis group (OR 0.43; 95% CI 0.29-0.65; P＜0.001) and right subclavian artery (RSA) / INA stenosis group (OR 0.36; 95% CI 0.19-0.69; P=0.002).
SSP is associated with lower prevalence of contralateral VAS.
锁骨下动脉窃血现象（SSP）与对侧椎动脉（VA）的动脉粥样硬化性狭窄之间是否存在关联尚不确定。我们旨在探讨体内SSP与对侧椎动脉狭窄（VAS）发生率之间的关联。
在这项前瞻性登记研究中，我们纳入了2011年至2022年期间来自我们综合卒中中心经数字减影血管造影（DSA）诊断为近端锁骨下动脉（SA）或无名动脉（INA）狭窄＞50%的患者。静息状态下通过DSA诊断VAS和SSP。根据是否存在SSP，对所有参与者和亚组进行1:1比例的倾向评分匹配（PSM）。我们进一步根据狭窄程度和SSP类型将所有参与者分为亚组进行敏感性分析。应用二项逻辑回归分析来研究SSP与对侧VAS的关联。
本研究共纳入774例患者，其中309例（39.9%）发现有SSP。PSM后，在所有参与者中，SSP的存在与对侧VAS的较低患病率相关（OR 0.45；95%CI 0.31 - 0.65；p＜0.001）。在亚组分析中，分别在左锁骨下动脉（LSA）狭窄组（OR 0.43；95%CI 0.29 - 0.65；P＜0.001）和右锁骨下动脉（RSA）/INA狭窄组（OR 0.36；95%CI 0.19 - 0.69；P = 0.002）中发现了这种关联。
SSP与对侧VAS的较低患病率相关。
