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Innovations in treatment
Case report
Subclavian steal syndrome treated by kissing stenting of the subclavian and vertebral arteries
  1. Rebecca Zener1,
  2. Jeff Jaskolka2 and
  3. Graham Roche-Nagle1,3
  1. 1Department of Interventional Radiology, Toronto General Hospital, Toronto, Ontario, Canada
  2. 2Department of Interventional Radiology, Brampton Civic Hospital, Brampton, Ontario, Canada
  3. 3Department of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Graham Roche-Nagle; graham.roche-nagle{at}uhn.ca

Abstract

The prevalence of subclavian artery (SA) stenosis is approximately 2%. The exact prevalence of extracranial vertebral artery (VA) stenosis is undetermined, with estimates ranging from 7% to 40%. Nearly 25% of ischaemic strokes involve the vertebrobasilar circulation, and arteriosclerotic disease and narrowing of the proximal VA may be the cause for up to one-fifth of these incidents. The bulk of SA stenoses occur proximally to the ostium of the VA. Vertebrobasilar ischaemia can be caused both by VA and SA stenosis. Surgical and endovascular approaches are potential treatment options for SA/VA stenosis. It has been demonstrated that endovascular intervention is considerably safer for this pathology, and with advances in device technology, angioplasty with stenting has become the preferred treatment option. We present the case of a 76-year-old man who presented with vertebrobasilar ischaemia from coexisting stenosis of the SA/VA which was treated by endovascular methods.

  • vascular surgery
  • interventional radiology

https://doi.org/10.1136/bcr-2019-233153

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    Footnotes

    • Contributors All authors meet criteria for authorship. Each author has made substantial contributions to the conception and design of the work, drafting of the report and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.