Asymptomatic high flow subclavian steal in a patient with hemodialysis access

The Journal of Vascular Access
Cédric BronErik Haesler

Abstract

Subclavian steal phenomenon due to proximal subclavian artery stenosis or occlusion is not un-common but often remains asymptomatic. We describe the case of a 66-year-old man with end-stage renal disease hemodialysed through a brachio-brachial loop graft of the left forearm. Echo-Doppler precerebral examination showed a high reversed flow of 570 ml/min in the ipsilateral vertebral artery. After successful endovascular recanalization of the subclavian artery, access blood flow increased and vertebral flow decreased to 30 ml/min. Complete neurological examination was normal both before and after endovascular treatment. This case demonstrates how high a subclavian steal can be without causing symptoms and how well precerbral and cerebral circulation can adapt to hemodynamic changes.

References

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Citations

Mar 31, 2015·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Kazutaka KukitaUNKNOWN Vascular Access Construction and Repair for Chronic Hemodialysis Guideline Working Group, Japanese Society for Dialysis Ther
May 12, 2015·Case Reports in Vascular Medicine·Eesha MaiodnaMohamed Samy Elhammady
Feb 7, 2017·The Journal of Vascular Access·Usman K HayatNicholas G Inston
Apr 27, 2012·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Stephen OsiroMarios Loukas

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