![]() Conservative treatment is the initial best therapy for this syndrome, with surgery reserved for refractory symptomatic cases. Doppler ultrasound is a useful screening tool, but the diagnosis must be confirmed by CT or MR angiography. Atherosclerosis of the SA remains the most common cause. Recent studies have shown a linear correlation between increasing arm blood pressure difference with the occurrence of symptoms. The syndrome, however, remains characteristically asymptomatic and solely poses no serious danger to the brain. Once thought to be rare, the emergence of new imaging techniques has drastically improved its diagnosis and prevalence. The symptoms from the compromised vertebrobasilar and brachial blood flows constitute the subclavian steal syndrome (SSS), and include paroxysmal vertigo, drop attacks and/or arm claudication. Subclavian ‘steal’ phenomenon is a function of the proximal subclavian artery (SA) steno-occlusive disease, with subsequent retrograde blood flow in the ipsilateral vertebral artery (VA). ![]()
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