Subclavian Steal Syndrome

Subclavian steal syndrome (synonyms: vertebral tapping syndrome; ICD-10 G45.8: other cerebral transient ischemia and related syndromes) is a so-called tapping syndrome. This refers to a condition in which blood is withdrawn from a specific area as a result of localized blood flow reversal.

In the case of subclavian steal syndrome, the subclavian artery (subclavian artery) is affected, arising on the right as a branch of the brachiocephalic trunk (arm-head vascular trunk; first major arterial branch of the aorta) and on the left directly from the aortic arch. As it continues, it becomes the axillary artery (axillary artery).

Sex ratio: males to females is 1.5-2: 1.

Frequency peak: The disease occurs with underlying atherosclerosis (arteriosclerosis, hardening of the arteries) predominantly in people over 50 years of age.

The prevalence (disease incidence) is 1.3% in patients in whom a carotid/vertebral Doppler has been requested (in Europe). Of these, approximately 5% present with neurologic symptoms. In the United States, the prevalence is 2.5% of the population, of which 5.3% are symptomatic. Overall, the prevalence is estimated to be higher because in many cases the disease is asymptomatic.

Course and prognosis: If occlusion occurs proximal to the branch of the vertebral artery,flow reversal occurs in the subclavian artery. If the arm is still loaded at this point,neurologic symptoms may occur because of decreased perfusion (reduced blood flow) to the arteries supplying the brain.