Cardiac cycle-dependent alternating flow in vertebral arteries with subclavian artery stenoses.

Abstract:

:Continuous-wave Doppler sonography is a reliable method for detecting severe subclavian stenosis and occlusion as well as subclavian steal. Intermediate stages leading to subclavian steal can also be detected. These are characterized by a cardiac-phase-dependent alternating flow direction in the vertebral artery. Some cases of proximal subclavian or proximal vertebral artery stenosis produce a systolic deceleration of flow in the vertebral artery. Stenosis and occlusion of the subclavian artery as well as stenosis of the subclavian and vertebral arteries can be distinguished. The pulse curve changes described can be reversed by a vascular by-pass. Alternating flow direction or systolic deceleration of flow in the radial artery could also be observed or induced in a iatrogenic model using Cimino's a-v fistula in the arm in patients on dialysis. The results in beginning subclavian steal situations can be applied in principle to other collateral circulations, and in particular to the hemodynamics in the region of watersheds.

journal_name

Stroke

journal_title

Stroke

authors

von Reutern GM,Pourcelot L

doi

10.1161/01.str.9.3.229

subject

Has Abstract

pub_date

1978-05-01 00:00:00

pages

229-36

issue

3

eissn

0039-2499

issn

1524-4628

journal_volume

9

pub_type

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