This document discusses subclavian steal phenomenon, which occurs when there is stenosis or occlusion of the subclavian artery causing blood to flow in reverse from the vertebral artery to supply the arm. It classifies subclavian steal based on which arteries are involved in the reverse blood flow. Common causes include atherosclerosis and cervical ribs. Clinical presentations include weak pulse and blood pressure differences in the arms. Diagnosis involves Doppler ultrasound, CT angiography or angiogram. Treatment options are balloon angioplasty, endarterectomy or bypass surgery. The incidence increases with age and it is more common in males and affects the left side more often.

1. Department Of
Anatomy
Prerana Mishra
MBBS-2013
K.G.M.U.

2.  1) Introduction
 2) Classification of Subclavian Steal Phenomenon
 3) Path Of Blood(Normal Vs SSS)
 4) Etiology
 5) Clinical Presentation
 (A) Ipsilateral Upper Limb Manifestations
 (B) Neurotological Syndrome
 (6) Diagnosis
 (7) Treatment
 (8) Epidemiology

3. SYNONYMS-
(a)Subclavian Steal
Phenomenon
(b) Suclavian Steal
Steno- Occlusive
Disease

4. Classification I Classification II
Vollmar and Colleagues Basis: Hemodynamic
disturbances of
vertebral artery
Vertebro-Vertebral Stage I: Occult Steal
Carotid-Basilar Stage II: Partial Steal
External Carotid-Vertebral Stage III: Complete Steal
Carotid-Subclavian

6. 1)Atherosclerosis 2)Cervical Rib

7. 3)Takayasu’s Arteritis
4) Congenital
(a) Interrupted Aortic
Arch
(b) Preductal Aortic
Co-arctation

8. 1)Weak or absent pulse
2)Decreased B.P.
(<20 mm Hg)
3)Arm Claudication
4)B.P. difference between
two arms
5)Hand showing circulation
problem(Blotchy Patches)

9. I) NEUROLOGICAL
1) Dizziness
2) Vertigo
3) Presyncope
4) Syncope
5) Ataxia
6) Dysarthria
7) Visual changes
8) Weakness

10. (II) OTOLOGICAL
1) Sensorineural Hearing
Loss
2) Tinnitus

11. 1)Doppler Ultrasound
2) CT Angiography 3) Angiogram

12. 1) Balloon Angioplasty
2) Endarterectomy
3) Bypass Surgery
4) Regular Follow-Ups

13. -> Increased incidence with age
-> Male : Female = 2 : 1
-> Left arm : Right Arm = 3 : 1

14.  Clinical Anatomy- Neeta V. Kulkarni
 Gross Anatomy- Kyung won Chung and
Harold M chung
 Clinical and surgical anatomy- Vishram Singh
 www.clinicalkey.com
 Gray’s Anatomy- Henry Gray
 Clinical Anatomy by Regions-Richard S. Snell