Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T13:16:05.750Z Has data issue: false hasContentIssue false
  • English
  • Français

Catheter interventions for “double steal” from isolation of the subclavian artery associated with patent arterial duct

Published online by Cambridge University Press:  06 March 2013

Nageswara R. Koneti ,
Shakeel A. Qureshi  and
Kothandam Sivakumar
Nageswara R. Koneti
Affiliation:
Department of Pediatric Cardiology, Care Hospital, Hyderabad, India
Shakeel A. Qureshi
Affiliation:
Department of Pediatric Cardiology, Evelina Children's Hospital, London, United Kingdom
Kothandam Sivakumar*
Affiliation:
Department of Pediatric Cardiology, MIOT Hospital, Chennai, India
*
Correspondence to: Dr K. Sivakumar, MD DM, Senior Consultant Cardiologist, Department of Pediatric Cardiology, MIOT Hospital, 4/112, Mount Poonamalle Road, Chennai 600089, India. Tel: +91 44 22492643; Fax: +91 44 22491188; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Isolation of the subclavian artery is associated with “steal” of blood from the carotid circulation to the arm, through the circle of Willis and the vertebral artery. When associated with a patent arterial duct, there is an additional “steal” of blood from the arm to the lungs, through the arterial duct because of the lower pulmonary vascular resistance. When this combination manifests clinically with arm ischaemia on the side of the isolated subclavian artery, closure of the arterial duct will prevent the “steal” of blood from the subclavian artery to the pulmonary artery and may improve the blood flow to the arm. We report three patients with this unusual combination of the “steal” phenomenon that improved after interventional closure of the arterial duct. This report discusses the embryological basis of the defect, clinical and echocardiographic clues to diagnose this unusual anomaly, angiographic findings, and transcatheter management options.

Keywords

Subclavian arteryisolationpatent arterial ductcatheter interventionssubclavian stealaortic arch anomaly
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 95 - 98
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. McElhinney, DB, Silverman, NH, Brook, MM, Reddy, VM, Hanley, FL. Rare forms of isolation of the subclavian artery: echocardiographic diagnosis and surgical considerations. Cardiol Young 1998; 8: 344–351.Google Scholar
2. Madan, N, Schnieder, DJ, Jacobs, ML. Right aortic arch, isolated left subclavian artery and ductus arteriosus with normal intracardiac anatomy: rare manifestation of chromosome 22q11 deletion. Pediatr Cardiol 2006; 27: 781–783.CrossRefGoogle ScholarPubMed
3. Vazquez-Jimenez, JF, Mühler, EG, Koch, D. Isolation of the left subclavian artery in a patient with Williams–Beuren syndrome. Heart 2001; 85: 609.CrossRefGoogle Scholar
4. Hokari, M, Kuroda, S, Furukawa, K, Houkin, K, Iwasaki, Y. Subclavian steal syndrome associated with the right aortic arch in a patient with Peutz–Jeghers syndrome: case report. No Shinkei Geka 2003; 31: 281–286.Google Scholar
5. Victoria, BE, Van Mierop, LHS, Elliott, LP. Right aortic arch associated with contralateral congenital subclavian steal syndrome. Am J Roentgenol 1970; 108: 582–590.CrossRefGoogle Scholar
6. Schreiber, C, Cleuziov, J, Eicken, A, Lange, R. Surgical treatment of isolated origin of right subclavian artery from pulmonary artery. Ann Thorac Surg 2009; 87: e8.Google Scholar
7. Mathieson, JR, Silver, SF, Gordon Culham, JA. Isolation of the right subclavian artery. Am J Roentgenol 1988; 151: 781–782.Google Scholar
8. Edwards, JE. Anomalies of the aortic arch system. Birth defects 1977; 13: 47–63.Google Scholar
9. Nath, H. Isolation of the right subclavian artery. Am J Roentgenol 1989; 152: 430–431.CrossRefGoogle ScholarPubMed
10. Jones, TK, Garabedian, H, Grifka, RG. Right aortic arch with isolation of the left subclavian artery, moderate patent ductus arteriosus and subclavian steal syndrome: a rare aortic arch anomaly treated with the Gianturco-Grifka vascular occlusion device. Catheter Cardiovasc Interv 1999; 47: 320–322.Google Scholar

Koneti Supplementary Material

Movie 1

Download Koneti Supplementary Material(Video)
Video 1.2 MB

Koneti Supplementary Material

Movie 2

Download Koneti Supplementary Material(Video)
Video 620.7 KB