Schwend R B, Hambsch K, Baker L, Kwan K, Torruella A, Otis S M
Vascular Laboratory Scripps Clinic and Research Foundation La Jolla, Ca, USA.
J Neuroimaging. 1995 Jul;5(3):195-7. doi: 10.1111/jon199553195.
The progression of subclavian arterial stenosis and the subsequent formation of collateral pathways serve to alter the pressure gradients in subclavian steal syndrome, altering ipsilateral vertebral artery flow from its normal state to "latent," "transient," and "continuous" steals. A similar altered flow in the carotid arteries can be observed with stenosis of the proximal common or innominate artery. A 59-year-old man was seen in the vascular laboratory for evaluation of symptomatic peripheral arterial disease. An incidental asymptomatic stenosis of the right innominate and left proximal subclavian artery was found. Further cerebral vascular evaluation displayed a continuous right subclavian steal and a latent steal in the right internal carotid artery. Transcranial Doppler examination displayed "transient" steal in the terminal right internal carotid artery. Combining duplex and transcranial Doppler evaluations allows sequential evaluation of the progression of arterial disease and its effect on the flow patterns in the cerebral vasculature.
锁骨下动脉狭窄的进展以及随后侧支循环途径的形成，会改变锁骨下动脉窃血综合征中的压力梯度，使同侧椎动脉血流从正常状态转变为“潜在性”“短暂性”和“持续性”窃血。在近端颈总动脉或无名动脉狭窄时，也可观察到颈动脉出现类似的血流改变。一名59岁男性因有症状的外周动脉疾病到血管实验室就诊。检查发现其右无名动脉和左近端锁骨下动脉存在偶然的无症状狭窄。进一步的脑血管评估显示存在持续性右锁骨下动脉窃血以及右颈内动脉潜在性窃血。经颅多普勒检查显示右侧颈内动脉终末段存在“短暂性”窃血。结合双功超声和经颅多普勒评估，能够对动脉疾病的进展及其对脑血管系统血流模式的影响进行连续评估。
