Your subclavian arteries run under your collarbones and supply blood to your arms and, on the left side, to part of your brain. When one of these arteries narrows, it can cause unusual symptoms: arm fatigue during activity, a noticeable difference in blood pressure between your two arms, or dizziness when you use your arm. These are subtle clues that something vascular may be going on, and they are worth checking out.
Subclavian Steal Syndrome
Subclavian steal syndrome occurs when severe stenosis or occlusion of the proximal subclavian artery causes blood to flow retrograde (backward) down the ipsilateral vertebral artery to supply the arm — literally stealing blood from the basilar circulation. During arm exercise, the demand for blood in the arm increases, worsening the reversal and producing posterior circulation symptoms including dizziness, syncope, visual blurring, ataxia, and rarely stroke.
Symptoms of Subclavian Stenosis
Many patients are asymptomatic, with subclavian stenosis discovered during evaluation for blood pressure asymmetry between the arms. Symptomatic patients may experience arm fatigue or claudication with use, a blood pressure difference greater than 15 mmHg between the arms, dizziness or vertigo particularly with arm exercise, coolness or pallor of the affected arm, and — in patients who have previously undergone coronary artery bypass using the internal mammary artery — recurrent angina from coronary-subclavian steal.
Treatment of Subclavian Stenosis in Sarasota & Bradenton
Symptomatic subclavian stenosis is treated with endovascular angioplasty and stenting — a catheter-based procedure with excellent technical success and low procedural risk. Stenting is performed via femoral or brachial artery access, and most patients experience immediate resolution of symptoms. Surgical carotid-subclavian bypass is an alternative for complex anatomy or endovascular failures and provides excellent long-term patency.