Ekeström S, Eklund B, Liljeqvist L, Nordhus O
Acta Med Scand. 1979;206(6):467-71. doi: 10.1111/j.0954-6820.1979.tb13548.x.
The preoperative investigation of 25 patients referred for evaluation of subclavian artery obliteration is reported. Non-invasive methods were used prior to angiography to assess arm circulation and the direction of blood flow in the vertebral artery. A retrograde flow in one vertebral artery was found in 18 patients, but only 7 had symptoms judged to be caused by the reversal of flow. In only one patient was the arm circulation so impaired as to justify the diagnosis of arm claudication. A high frequency of carotid lesions was found on the angiograms. The report demonstrates that in cases of suspected subclavian steal and/or arm claudication due to a subclavian artery obliteration, non-invasive methods should be used to screen the patients before angiography. In many cases it will be found that symptoms cannot be attributed to steal or impairment of the arm circulation and therefore angiography is not indicated. However, in some cases signs of a coexistent carotid lesion may still necessitate angiography.
报告了25例因锁骨下动脉闭塞前来评估的患者的术前检查情况。在血管造影之前使用非侵入性方法评估手臂循环以及椎动脉内的血流方向。18例患者发现一侧椎动脉存在逆流，但只有7例有被判定为由血流逆转引起的症状。仅1例患者的手臂循环受损程度足以诊断为手臂间歇性跛行。血管造影显示颈动脉病变的发生率很高。该报告表明，在怀疑因锁骨下动脉闭塞导致锁骨下动脉窃血和/或手臂间歇性跛行的病例中，应在血管造影之前使用非侵入性方法对患者进行筛查。在许多情况下，会发现症状不能归因于窃血或手臂循环受损，因此不需要进行血管造影。然而，在某些情况下，并存颈动脉病变的迹象可能仍需要进行血管造影。
