Subclavian Arterial Disease

What is Subclavian Arterial Disease?

Subclavian arterial disease — also known as subclavian steal syndrome and aortic arch syndrome — involves structural problems or blockages in the arteries that branch off from the aortic arch. The aortic arch is the top portion of the main artery carrying blood away from the heart.

Causes

• Hardening of the arteries (atherosclerosis)
• Blood clots
• Birth defects
• Trauma
• Embolisms
• Takayasu's arteritis
• Vigorous exercise of the body part (such as an arm) where symptoms are felt

Risk Factors

• High blood pressure
• Diabetes
• Smoking
• High cholesterol

What are the Symptoms?

• Dizziness
• Blurred vision
• Weakness
• Transient ischemic attacks, or "mini-strokes"
• Sudden changes in blood pressure
• Reduced pulse
• Arm numbness

How is Subclavian Arterial Disease Diagnosed?

• Ultrasound Imaging: Sound waves are used to measure blood flow in the artery and determine whether there is a blockage.
• Computed Tomography (CT) scan and CT Angiography: X-ray slices of the neck and brain are taken to determine if there are any areas with poor blood flow or narrow arteries. A patient may be injected with a dye that will help make blood vessels visible on the scan.
• Angiography: A dye is inserted into the arteries through a catheter, then an X-ray is taken to show how blood flows through the arteries and whether any arteries are narrowed or blocked.

Treatment at UVA's Heart and Vascular Center

• Endarterectomy: An endarterectomy is a surgical procedure where plaque causing a narrowing or blockage in the aortic arch arteries is removed, opening the affected artery and improving blood flow.
• Angioplasty and stenting: In this procedure, a surgeon inserts a catheter with a balloon on its tip and runs it to the area of the artery that is blocked or narrowed. The balloon is inflated, pushing the plaque to the artery walls and opening up the artery. A small tube called a stent is then inserted to keep the artery open.