Walker P M, Paley D, Harris K A, Thompson A, Johnston K W
J Vasc Surg. 1985 Jan;2(1):154-7. doi: 10.1067/mva.1985.avs0020154.
Symptoms associated with subclavian artery stenosis are related to reduced cerebral or arm blood flow. A large difference in blood pressure between the two arms is associated with symptoms of arm ischemia alone and is usually caused by an anatomic variant. The presence or absence of a radiologic steal alone did not seem to determine the type or presence of symptoms. The type of cerebral symptoms seems to be determined by the location of other extracranial vascular stenosis. In patients with hemispheric symptoms there was a higher incidence of anterior circulation insufficiency and a greater reduction in the overall cerebral blood flow. In patients with nonhemispheric symptoms a higher incidence of posterior circulation insufficiency occurred. There may be a small group with nonhemispheric symptoms and a subclavian artery stenosis in whom reversed vertebral artery blood flow is the sole determinant. Perhaps more accurate delineation of other extracranial vascular stenosis would help determine what stenosis in addition to the subclavian artery occlusive disease determines the presenting symptoms. Surgical repair of these lesions may lead to an improved cure rate in this group of patients.
与锁骨下动脉狭窄相关的症状与脑血流量或手臂血流量减少有关。双臂血压的显著差异仅与手臂缺血症状相关，通常由解剖变异引起。单纯放射学上的盗血现象的存在与否似乎并不能决定症状的类型或是否出现。脑症状的类型似乎由其他颅外血管狭窄的位置决定。有半球症状的患者前循环供血不足的发生率较高，全脑血流量的减少幅度更大。有非半球症状的患者后循环供血不足的发生率较高。可能有一小部分有非半球症状且患有锁骨下动脉狭窄的患者，其椎动脉血流逆转是唯一的决定因素。或许更准确地描绘其他颅外血管狭窄情况将有助于确定除锁骨下动脉闭塞性疾病外，还有哪些狭窄决定了当前症状。对这些病变进行手术修复可能会提高这组患者的治愈率。
