The Role of Carotid Ultrasonography In Revealing Subclavian Steal Syndrome

Background: Subclavian steal syndrome (SSS) is quite rare; the prevalence is estimated to be between 0.6%–6%. As much as 80% of patients may present as asymptomatic. It is important to diagnose SSS promptly, as further management including vascular surgical treatment may be planned early on. Carotid Doppler (CD) ultrasonography is may demonstrate reversal of flow to establish diagnosis of SSS.
Method: This is a descriptive study where subjects are all non-hemorrhagic stroke patients in CiptoMangunkusumo Hospital in 2014, upon whom CD of the internal carotid arteries (ICA) and vertebra-basilar arteries (VA) was performed. When there is a clinical suspicion of SSS, techniques are done to demonstrate reversal of flow.
Results: 576 subjects were found to be eligible, among which two subjects (0.3%) were confirmed to have SSS. Subjects are male, ages >55 years old, presenting with neurological deficits associated with compromised posterior circulation i.e. symptoms of cerebellar function at onset; the first subject, presented with sudden dizziness, the second subject presented with slurred speech. Subjects also suffered from stage two hypertension and dyslipidemia. CD in both subjects showed reverse flow of the left VA. CT-angiography of one subject showed stenosis and distal occlusion of the left VA.