open access
Ultrasound and angiographic assessment of collateral circulation in bilateral steal syndrome
open access
Abstract
Material and methods. The examinations were performed in three symptomatic patients suffering from bilateral subclavian steal syndrome. Doppler examination, including extracranial artery flow measurement, was made with the use of a 5-9 MHz linear head. Examination of the basilar artery through the great foramen as well as of the posterior communicating arteries and the posterior cerebral arteries through the parietal window was made with the use of a 2.5 MHz sector head. Development of steal was assessed in 3-stage scale. Angiographic examinations were made using the Seldinger method, and providing contrast medium to the ascending aorta and the aortic arch branch.
Results. Significant haemodynamic disorders, along with a total flow reversal in the homonymous vertebral artery in the case of subclavian artery occlusion, and along with a bidirectional flow in the vertebral artery in the case of subclavian artery stenosis, were found respectively. Each time, well-developed collateral circulation from the external carotid arteries through the occipital arteries or through the superior thyroid arteries was observed. Moreover, the presence of tiny collateral vessels directly from the aorta was also found.
Conclusions. Doppler arterial examination is a valuable type of examination for diagnosing and assessing steal syndrome. In symptomatic patients, diagnostics must be indispensably accompanied by angiographic examinations.
Abstract
Material and methods. The examinations were performed in three symptomatic patients suffering from bilateral subclavian steal syndrome. Doppler examination, including extracranial artery flow measurement, was made with the use of a 5-9 MHz linear head. Examination of the basilar artery through the great foramen as well as of the posterior communicating arteries and the posterior cerebral arteries through the parietal window was made with the use of a 2.5 MHz sector head. Development of steal was assessed in 3-stage scale. Angiographic examinations were made using the Seldinger method, and providing contrast medium to the ascending aorta and the aortic arch branch.
Results. Significant haemodynamic disorders, along with a total flow reversal in the homonymous vertebral artery in the case of subclavian artery occlusion, and along with a bidirectional flow in the vertebral artery in the case of subclavian artery stenosis, were found respectively. Each time, well-developed collateral circulation from the external carotid arteries through the occipital arteries or through the superior thyroid arteries was observed. Moreover, the presence of tiny collateral vessels directly from the aorta was also found.
Conclusions. Doppler arterial examination is a valuable type of examination for diagnosing and assessing steal syndrome. In symptomatic patients, diagnostics must be indispensably accompanied by angiographic examinations.
Keywords
steal syndrome; Doppler examinations; haemodynamics
About this articleTitle
Ultrasound and angiographic assessment of collateral circulation in bilateral steal syndrome
Journal
Issue
Article type
Research paper
Pages
212-221
Published online
2005-11-20
Page views
698
Article views/downloads
3076
Bibliographic record
Acta Angiologica 2005;11(4):212-221.
Keywords
steal syndrome
Doppler examinations
haemodynamics
Authors
Robert Juszkat
Marcin Gabriel
Violeta Nowak
Katarzyna Pawlaczyk
Fryderyk Pukacki
Grzegorz Oszkinis
Wacław Majewski