Subclavian steal syndrome

Case contributed by Dr Hani Makky Al Salam

Presentation

Dizziness and syncope.

Patient Data

Age: 65 years
Gender: Female
Ultrasound

Biphasic flow in the left vertebral artery. Normal spectral trace in the right vertebral artery. 

CT

High-grade Stenosis of the first part of the subclavian artery. 

Case Discussion

Subclavian steal phenomenon occurs where there is a high-grade stenosis at the first part of the subclavian artery, with reversal of flow in the ipsilateral vertebral artery. In patients with inadequate cerebral collateral supply, they can develop posterior circulation symptoms and then this condition is called subclavian steal syndrome. 

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