Yamaguchi K, Uchiyama S
Department of Neurology, Toyama Red Cross Hospital.
Rinsho Shinkeigaku. 1993 Sep;33(9):945-50.
The subclavian steal syndrome (SSS) is often associated with occlusive disease involving the subclavian or innominate arteries, but an asymptomatic subclavian steal, called the "subclavian steal phenomenon" (SSP), is not uncommon. Though intracranial collaterals had been postulated as one of the etiologies for the SSP's being asymptomatic, little has been accomplished in the investigation of extracranial channels. To study the hemodynamic role of cervical collateral channels, an angiographical study was done in three cases with SSP. The three cases were admitted to the hospital because of carotid ischemic symptoms, such as right hemiplegia or sensory aphasia. Each case had a blood pressure difference between the two arms, but in all of them the past history or the exercise test was negative for vertebrobasilar or arm ischemia. On angiography, occlusions of the unilateral proximal subclavian artery, the left in case 1 and the right in case 2, or a tight stenosis of the innominate artery was found in case 3. In each case, the vertebral artery flow in the affected side was inverted, siphoning off from the opposite vertebral artery into the affected subclavian artery. In addition to the vertebral siphoning; muscular branches of ipsilateral external carotid origin in cases 1 and 2, or the thyrocervical trunk via the inferior thyroid artery in case 3 was also found to function as a collateral channel to the vertebral artery on the affected side.(ABSTRACT TRUNCATED AT 250 WORDS)
锁骨下动脉盗血综合征（SSS）常与涉及锁骨下动脉或无名动脉的闭塞性疾病相关，但一种无症状的锁骨下动脉盗血，即“锁骨下动脉盗血现象”（SSP）并不少见。尽管颅内侧支循环被认为是SSP无症状的病因之一，但在颅外通道的研究方面进展甚微。为研究颈部侧支通道的血流动力学作用，对3例SSP患者进行了血管造影研究。这3例患者因颈动脉缺血症状入院，如右侧偏瘫或感觉性失语。每例患者双上肢血压均有差异，但既往史或运动试验均未提示椎基底动脉或上肢缺血。血管造影显示，病例1左侧、病例2右侧单侧近端锁骨下动脉闭塞，病例3无名动脉严重狭窄。在每例患者中，患侧椎动脉血流方向逆转，从对侧椎动脉虹吸至患侧锁骨下动脉。除了椎动脉虹吸现象外，病例1和病例2中同侧颈外动脉起源的肌支，或病例3中通过甲状腺下动脉的甲状颈干，也被发现作为患侧椎动脉的侧支通道发挥作用。（摘要截短于250字）
