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  • Title: Asymptomatic high flow subclavian steal in a patient with hemodialysis access.
    Author: Bron C, Hirt L, Halabi G, Saucy F, Qanadli SD, Haesler E.
    Journal: J Vasc Access; 2010; 11(1):63-5. PubMed ID: 20119915.
    Abstract:
    INTRODUCTION: Subclavian steal phenomenon due to proximal subclavian artery stenosis or occlusion is not un-common but often remains asymptomatic. CASE REPORT: 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. DISCUSSION: 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.
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