Common carotid artery occlusion with partial subclavian steal syndrome
The patient mainly complains and suffers from cough and shortness of breath.
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The left side has shown an acute thrombus causing total blockage throughout the common carotid artery from proximal to distal part.
Huge collateral has been spotted on and chased to be found feeding the internal carotid artery.
The left vertebral artery has demonstrated "rabbit-shaped" spectral trace, which indicates partial subclavian steal syndrome.
Left subclavian artery proximally has an elevated peak systolic velocity to 370 cm/s.
A 60-year-old male patient has turned up for Carotid Duplex assessment. The patient has presented walking with full control. No previous images were taken. The patient has had no injury and takes his medication as instructed. The study has demonstrated right common carotid artery occlusion. During the assessment left vertebral artery waveform has shown a different waveform than usual. Normal vertebral artery waveform appears as low resistance. In this case, vertebral artery appeared as in "rabbit shape" which does indicate partial subclavian steal syndrome.
As this finding leads to further images of the subclavian artery, it has been found that the ipsilateral subclavian artery has severe stenosis, giving an early sign of complete subclavian steal syndrome.
Subclavian steal is known as retrograde blood flow in the vertebral artery that indicates whether proximal ipsilateral subclavian artery stenosis or total occlusion.
- C.P. Oates a,*, A.R. Naylor b, T. Hartshorne b, S.M. Charles c, T. Fail d, K. Humphries e, M. Aslam f, P. Khodabakhsh g. (2009). Joint Recommendations for Reporting Carotid Ultrasound Investigations in the United Kingdom. Available: https://www.bmus.org/static/uploads/resources/Recommendations_for_reporting_Carotid_Investigations.pdf. Last accessed 30th Dec 2018.
- Ray Gaiser, Traci B. Fox (2016). Vascular Technology Examination PREP (LANGE Reviews Allied Health). New York: MC Graw Hill. 93-99.