Subclavian artery stenosis
Subclavian artery stenosis (SAS) refers to narrowing of one or both of the subclavian arteries.
The estimated in the general population as a whole is thought to be around 2-4%, while in those with peripheral vascular disease, it can be as high as 18% 1,4.
It can arise of number pathological condition with atherosclerosis being the most common by far.
Other rare causes include
- arteritis affecting the subclavian artery.
- vascular compression syndromes
- fibromuscular dysplasia
- neurofibromatosis type 1
The left subclavian is considered to 4 times more commonly affected than the right or innominate artery 1.
- up to 50% of patients may have concurrent coronary artery disease
May show evidence of subclavian steal on the ipsilateral side.
Allows direct visualisation of degree and extent of stenosis.
Treatment and prognosis
Management options include
- angioplasty +/- stenting
- surgical management (bypass)
Some publications have shown that the presence of subclavian stenosis is an independent predictor for total cardio-vascular disease mortality 6.
Article being written - feel free to help.:)
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- 2. Hua Y, Jia L, Li L et-al. Evaluation of severe subclavian artery stenosis by color Doppler flow imaging. Ultrasound Med Biol. 2011;37 (3): 358-63. doi:10.1016/j.ultrasmedbio.2010.12.003 - Pubmed citation
- 3. Klein JJ, McFalls EO, Cummings MJ et-al. Images in cardiovascular medicine. Proximal subclavian artery stenosis diagnosis and repair documented by both myocardial perfusion imaging and angiography. Circulation. 2004;109 (16): e191-3. doi:10.1161/01.CIR.0000127131.79178.80 - Pubmed citation
- 4. Shadman R, Criqui MH, Bundens WP et-al. Subclavian artery stenosis: prevalence, risk factors, and association with cardiovascular diseases. J. Am. Coll. Cardiol. 2004;44 (3): 618-23. doi:10.1016/j.jacc.2004.04.044 - Pubmed citation
- 5. Burihan E, Soma F, Iared W. Angioplasty versus stenting for subclavian artery stenosis. Cochrane Database Syst Rev. 2011; (10): CD008461. doi:10.1002/14651858.CD008461.pub2 - Pubmed citation
- 6. Aboyans V, Criqui MH, McDermott MM et-al. The vital prognosis of subclavian stenosis. J. Am. Coll. Cardiol. 2007;49 (14): 1540-5. doi:10.1016/j.jacc.2006.09.055 - Pubmed citation