Endovascular treatment of Steel Syndrome
- Dyulgerov, K. Genova
Steal syndrome is defined as steno-occlusive disease in 1st segment of subclavian artery with retrograde blood flow in ipsilateral vertebral artery. As a result the blood flow to the corresponding arm is reduced and apart from collaterals, is performed primarily by retrograde blood flow from the ipsilateral vertebral artery. Blood is ‚stolen‘ from the circular vertebrobasilar system to supply the distal territory of the occluded or stenosed artery. Clinical appearances vary in severity and include (a) from upper limb side – weakness, thirst, cold, decreased blood pressure of the respective arm, pain and (b) neurological – increasing in the physical load of the respective hand: dizziness, syncope, ataxia. The main cause of Steel Syndrome (95% of cases) is atherosclerosis and as part of PAD (peripheral arterial disease) is the subject of endovascular treatment. PTA (Percutaneous transluminal angioplasty) is characterized by minimal invasiveness (only local anesthesia is used), less complications, shorter time for hospitalization and reduced cost (even involving the need for re-interventions in some patients). Endovascular treatment with its safety, efficacy and relatively low cost has been proven to be an alternative to the treatment of stenocclusive disease in subclavian arteries. We present a case from our practice of diagnostics and endovascular treatment of Steal syndrome.
Key words: STEAL SYNDROM. STENT. ENDOVASCULAR TREATMENT. PERIPHERAL ARTERIAL SYNDROM (PAD). PERCUTANEUS TRANSLUMINAL ANGIOPLASTY (PTA).