SUBCLAVIAN STEAL SYNDROME

Course overview

SUBCLAVIAN STEAL SYNDROME (SSS), NOW TERMED SUBCLAVIAN-VERTEBRAL ARTERY STEAL SYNDROME, REFERS TO THE DIVERSION OF BLOOD FLOW AWAY FROM ITS NORMAL TARGET AND THE ARM. IT IS A CAUSE OF SYNCOPE OR PRESYNCOPE RELATED TO CEREBRAL HYPOPERFUSION THAT OCCURS DURING ARM USE. THIS CONDITION COMMONLY RESULTS FROM ARTERIOVENOUS MALFORMATIONS THAT ARE EITHER CONGENITAL OR IATROGENIC. A CORONARY VARIANT OF SUBCLAVIAN-VERTEBRAL ARTERY STEAL SYNDROME CAN OCCUR AS AN ADVERSE EFFECT OF CORONARY ARTERY BYPASS WHEN USING THE ARM ON THE SAME SIDE OF THE INTERNAL MAMMARY ARTERY GRAFT USED TO BYPASS THE NARROWED OR OBSTRUCTED CORONARY VESSEL. THIS VARIANT USUALLY RESULTS IN SYMPTOMS OF CARDIAC ISCHEMIA SUCH AS ANGINA OR, IN SEVERE CASES, CAN CAUSE MYOCARDIAL INFARCTION. THE DEFINING FEATURE OF SUBCLAVIAN-VERTEBRAL ARTERY STEAL SYNDROME IS THE PATHOPHYSIOLOGIC PHENOMENON OF TAKING BLOOD FLOW AWAY FROM THE VERTEBROBASILAR OR CORONARY CIRCULATION AND DIVERTED TO THE ARM. THIS ACTIVITY ILLUSTRATES THE EVALUATION AND TREATMENT OF SUBCLAVIAN-VERTEBRAL ARTERY STEAL SYNDROME AND REVIEWS THE ROLE OF INTERPROFESSIONAL TEAM MEMBERS IN MANAGING THOSE WITH THIS CONDITION.