The Subclavian Steal Syndrome
1970; Elsevier BV; Volume: 9; Issue: 1 Linguagem: Inglês
10.1016/s0003-4975(10)66110-3
ISSN1552-6259
AutoresVincent A. Piccone, Harry H. LeVeen,
Tópico(s)Oropharyngeal Anatomy and Pathologies
Resumohe subclavian steal syndrome is characterized by cerebral ischemic attacks caused by reversal of blood flow through the verte-T bral artery consequent to arterial obstruction proximal to the origin of the vertebral artery (Fig. 1).While not a separate disease entity, the subclavian steal syndrome relates cerebral ischemia to a remote vascular lesion which is surgically correctable and more frequent than was anticipated. HISTORYT h e anastomotic channels supplying the subclavian artery beyond a proximal occlusion were well described by the anatomists [54].Detailed collateral pathways are found in Tagariello's work with dogs and cadavers [94].Contorni [ 141 demonstrated the vertebral-basilar-vertebral collateral artery flow with angiograms in human subjects for the first time in 1960.Contrast medium injected into the contralateral brachial artery of an asymptomatic patient with an absent left radial pulse flowed up the right vertebral artery, down the left vertebral artery, and onward to the left subclavian artery just distal to the occlusion.Rob [79], Toole [981, and Fields [29] discussed the "siphon" of the vertebral collateral artery at the third Princeton Conference on Cerebrovascular Diseases in January, 1961.Thus, while the necessity for brachiad flow in the vertebral collateral artery was recognized, the causal relationship between cerebral ischemic attacks and occlusion of the proximal subclavian artery remained obscure until later in 1961.Then Reivich and associates [78], in several case reports and animal experiments, clearly associated cerebral ischemic attacks with the reversed vertebral flow described by Contorni.At the same time, an editorial in the New
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