Case report

Right subclavian double steal syndrome: a case report

Konstantinos Filis¹ , Levon Toufektzian¹ , Frangiska Sigala¹ , Dimitrios Kardoulas¹ , Aikaterini Kotzadimitriou² , Emmanuel Lagoudianakis¹ , Nikolaos Koronakis² and Andreas Manouras¹

¹  Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece

²  Second Department of Surgery, 417NIMTS – Nosileutiko Idrima Metohikou Tameiou Stratou (Military Veterans' Fund Hospital), Athens, Greece

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Journal of Medical Case Reports 2008, 2:392doi:10.1186/1752-1947-2-392

Published:	23 December 2008

Abstract

Introduction

Double-steal syndrome represents a causative factor for blood flow compromise of the cerebral vascular bed with transient neurologic symptoms. We present the case of a patient with innominate artery atherosclerotic occlusion, manifested as blood flow reversal in the vertebral and common carotid arteries. Symptomatic atherosclerotic occlusive disease of the innominate artery is relatively rare and represents less than 2% of all extracranial causes of cerebrovascular insufficiency.

Case presentation

We report on a 73-year-old male patient who presented at our hospital for the evaluation of dizziness and episodes of syncope. Angiography and color Doppler examinations documented the double syndrome as retrograde flow in the right vertebral artery and the right carotid artery.

Conclusion

Constituting an indication for surgical correction, his condition was managed with the performance of carotid-carotid extra-anatomic bypass for the permanent reestablishment of antegrade blood flow in the vascular network supplying the brain. Carotid-carotid extra-anatomic bypass was a good option for our patient, since he remains symptom free after one year of follow up.