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November 1983

Surgically Induced Carotid Subclavian Steal Syndrome: Diagnosis by Video Dilution Technique

Author Affiliations

From the Departments of Surgery (Drs Hunter and Carson) and Radiology (Dr Palmaz), Veterans Administration Medical Center, Martinez, Calif, and the Department of Radiology, University of California—Davis Medical Center (Dr Lantz), Sacramento.

Arch Surg. 1983;118(11):1325-1329. doi:10.1001/archsurg.1983.01390110071015

• A rare occurrence of carotid subclavian steal syndrome following carotid subclavian bypass for arm ischemia was described. Blood flows in the carotid artery and carotid subclavian bypass, at rest and following arm exercise, were determined by video dilution technique during the angiographic procedure. There was no obstruction of the inflow or outflow of the proximal or distal anastomoses to account for the steal (55%). Rather, increased arterial flow to the subclavian artery due to the patient's status as a bilateral amputee was thought to be the cause. The diagnosis and subsequent correction by takedown of this bypass and conversion to an axillary-to-axillary bypass were performed. Video dilution technique offers a unique and accurate way to study steal phenomena in conjunction with routine angiography and does not add to the patient's cost or risk.

(Arch Surg 1983;118:1325-1329)

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