Abstract
We experienced a case of subclavian steal syndrome (SSS) with specific obstruction of the right proximal subclavian artery. The patient was a 44-year-old man who complained of numbness of the right hand. Right carotid-subclavian artery anastomosis was performed under general anesthesia. Postoperatively, the patient was free from the symptom. The obstructed segment was a fibrous cord 3.5cm in length and 2mm in diameter. The cause was thought to be congenital malformation.
In a review of the Japanese literature, 73 cases were reported from 1965 to 1986, and the pathophysiology, was described in 64 cases as follows: Aortitis syndrome in 28 cases (43.8%), arteriosclerotic lesions in 22 (34.4%), congenital malfomations in 13 (20.3%), and iatrogenic lesion in one (1.6%). These data indicated that of arteriosclerotic lesions and the occurrence of congenital malformations was not as rare as previously thought.
Of 13 cases with congenital malformations, three had a similar aspect to our case. All four cases were male (aged 34, 29, 43 and 44 years) with a fibrous cord at the right proximal subclavian artery. None had cadiovascular anomaly.
