von Reutern G M, Pourcelot L
Stroke. 1978 May-Jun;9(3):229-36. doi: 10.1161/01.str.9.3.229.
Continuous-wave Doppler sonography is a reliable method for detecting severe subclavian stenosis and occlusion as well as subclavian steal. Intermediate stages leading to subclavian steal can also be detected. These are characterized by a cardiac-phase-dependent alternating flow direction in the vertebral artery. Some cases of proximal subclavian or proximal vertebral artery stenosis produce a systolic deceleration of flow in the vertebral artery. Stenosis and occlusion of the subclavian artery as well as stenosis of the subclavian and vertebral arteries can be distinguished. The pulse curve changes described can be reversed by a vascular by-pass. Alternating flow direction or systolic deceleration of flow in the radial artery could also be observed or induced in a iatrogenic model using Cimino's a-v fistula in the arm in patients on dialysis. The results in beginning subclavian steal situations can be applied in principle to other collateral circulations, and in particular to the hemodynamics in the region of watersheds.
连续波多普勒超声检查是检测严重锁骨下动脉狭窄和闭塞以及锁骨下动脉盗血的可靠方法。导致锁骨下动脉盗血的中间阶段也能被检测到。这些阶段的特征是椎动脉中血流方向随心动周期而交替变化。一些近端锁骨下动脉或近端椎动脉狭窄的病例会导致椎动脉血流出现收缩期减速。锁骨下动脉的狭窄和闭塞以及锁骨下动脉和椎动脉的狭窄可以被区分开来。所描述的脉搏曲线变化可通过血管旁路手术得到逆转。在透析患者中，使用手臂上的西米诺动静脉内瘘的医源性模型，也可观察到或诱发桡动脉血流方向交替或血流收缩期减速。锁骨下动脉盗血初期情况的结果原则上可应用于其他侧支循环，特别是分水岭区域的血流动力学。
