Subclavian Steal: Diagnostic Value of Reactive Hyperemia During Visual and Auditory Evoked Potential Recordings
Subclavian steal syndrome was described some decades ago by Contorni4 and Reivich et al. 13 as a peculiar phenomenon due to a hemodynamic mechanism and characterized by reversal of blood flow through the vertebral artery. This particular condition is sometimes asymptomatic, and the only finding that make it suspect is different pulses in the two arms. Upper limb exercise can precipitate the steal and produce an increased pressure gradient between the pre-stenotic and post-stenotic portions of the vessel affected by the obstruction. Dynamic exercise or reactive hyperemia may therefore be useful as a provocative test for clinical evaluation14 or in conjunction with directional Doppler sonography11 and angiography8.
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