Avtor/Urednik     Flis, V; Mrđa, B; Szalai, G; Agoston, I; Matela, J
Naslov     Subclavian obliteration and steal syndrome: when to operate? Case reports
Prevedeni naslov     Zapora arterije subklavije in kradežni sindrom: kdaj operativna terapija? Prikaz primerov
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 64, št. 7-8
Leto izdaje     1995
Obseg     str. 393-7
ISSN     1318-0347
Jezik     eng
Abstrakt     Background. Significant stenosis or obliteration of the central part of subclavian artery may produce a subclavian steal phenomenon, in which a retrograde flow in the vertebral artery to the post occlusive subclavian artery is demonstrable by angiography or Doppler sonography. Methods. However, the majority of patients with subclavian steal phenomenon may be asymptomatic, without major clinical signs of steal syndrome. Therefore, the risk and the benefits of surgical treatment must be very carefully weighed against medical therapy or even no therapy. This means that even among patients with subclavian steal syndrome only a small proportion will benefit from surgical therapy. To illustrate the clinical decision-making process for the patients with obliteration of the central part of subclavian artery three patients with subclavian steal phenomenon are presented. Results and conclusions. In the first patient, the vertebrobasilar symptoms presented genuine hazard to him. He was successfully operated. In the second patient, the vertebrobasilar symptoms were manifested as disabling arm claudication. He was successfully operated, too. Both patients have been asymptomatic after surgery. In the third patient, the subclavian steal phenomenon was detected during diagnostic procedures mode because of absence of pulse on her right hand. As she experienced only slight discomfort in her right hand during the exercise, surgery was not recommended. After four years of follow-up, her clinical situation is stable.
Izvleček     Izhodišča. Pomembna zožitev ali zapora začetnega dela arterije subklavije lahko povzroči kradežni pojav, pri katerem kri priteka v roko v povratnem toku prek vertebralne arterije. Metode. Pojav je mogoče prikazati z angiografijo ali doplersko sonografijo. Vendar pa večina bolnikov s kradežnim pojavom arterije subklavije nima hujših kliničnih znakov kradežnega sindroma. Tako je potrebno pri bolnikih s kradežnim sindromom natančno pretehtati tveganje in korist kirurškega zdravljenja v primerjavi z ostalimi možnostmi, kar z drugimi besedami pomeni, da bo celo med bolniki s kliničnimi znaki kradežnega pojava sorazmerno majhno število tistih, ki bodo imeli korist od kirurškega zdravljenja. Da bi prikazali način kliničnega odločanja pri bolnikih z zaporo centralnega dela arterije subklavije, predstavljamo tri bolnike s kradežnim pojavom arterije subklavije. Rezultati in zaključki. Prvi je bolnik z vertebrobazilarnim sindromom, ki je ogrožal njegovo življenje. Bolnik je vil uspešno operiran. Drugi bolnik je imel hhudo klavdikacijsko bolečino v roki. Tudi on je bil uspešno operiran. Pri tretji bolnici smo ugotovili kradežni pojav med preiskavami zaradi odsotnosti pulzov na arterijah desne roke. Ker bolnica pri fizičnih aktivnostih ni imela večjih težav z desno roko, ji operacije nismo svetovali. Po štiriletni spremljavi se njeno klinično stanje ni spremenilo.
Deskriptorji     SUBCLAVIAN STEAL SYNDROME