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Basilar Artery Blood Flow in Subclavian Steal

Published online by Cambridge University Press:  18 September 2015

Natan M. Bornstein
Affiliation:
Stroke Research Unit, Sunnybrook Medical Centre, University of Toronto, Toronto
Adam Krajewski
Affiliation:
Stroke Research Unit, Sunnybrook Medical Centre, University of Toronto, Toronto
John W. Norris*
Affiliation:
Stroke Research Unit, Sunnybrook Medical Centre, University of Toronto, Toronto
*
Sunnybrook Medical Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5
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Abstract:

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Subclavian “steal”, when blood siphons from one vertebral artery to the other, has been suggested as a cause of brain stem ischaemia and stroke. We investigated 33 patients using transcranial Doppler to determine the direction and velocity of basilar blood flow. All patients had severe subclavian stenosis with reversed vertebral blood flow in the ipsilateral artery previously demonstrated by extracranial Doppler. Basilar flow was normal in direction in all cases, but its velocity was significantly increased (p<0.0008) compared to age- and sex-matched controls. These findings, in conjunction with previous observations using extracranial Doppler techniques, suggest that subclavian steal is little more than a harmless haemodynamic phenomenon.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1988

References

REFERENCES

1.Fields, WS. Reflections on “the subclavian steal”. Stroke 1970; 1: 320324.CrossRefGoogle Scholar
2.Reivich, M, Holling, HE, Roberts, B, et al. Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med 1961; 265: 878885.CrossRefGoogle ScholarPubMed
3.Editorial: A new vascular syndrome — “the subclavian steal”. N Engl J Med 1961; 265: 912913.CrossRefGoogle Scholar
4.Bomstein, NM, Norris, JW. Subclavian steal: a harmless haemodynamic phenomenon? Lancet 1986; 2: 303305.Google Scholar
5.Aaslid, R, Markwalder, TM, Nornes, H. Non-invasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982; 57: 769774.CrossRefGoogle Scholar
6.Halsey, JH, McDowell, HA, Gelman, S. Transcranial Doppler and rCBF compared in carotid endarterectomy. Stroke 1986; 17: 12061208.CrossRefGoogle ScholarPubMed
7.von Reutern, GM. Functional and morphological evaluation of the cerebral circulation by ultrasound. In: Poch, K, Freund, HJ, Ganshirt, H, eds. Neurology. Berlin, Springer 1986: 441452.CrossRefGoogle Scholar
8.Arnolds, BJ, von Reutern, G-M. Transcranial Doppler sonography. Examination technique and normal reference values. Ultrasound Med Biol 1986; 12: 115123.CrossRefGoogle ScholarPubMed
9.Hennerici, M, Klemm, C, Rautenberg, W. The subclavian steal syndrome: a common vascular disorder with rare neurologic deficits. Neurology 1987; 37(suppl 1): 316.Google Scholar
10.Heyman, A, Young, WG, Dillon, M, et al. Cerebral ischemia caused by occlusive lesions of the subclavian or innominate arteries. Arch Neurol 1964; 10: 581589.CrossRefGoogle ScholarPubMed
11.Lord, RSA, Adar, R, Stein, RL. Contribution of the circle of Willis to the subclavian steal syndrome. Circulation 1969; 40: 871878.CrossRefGoogle Scholar