课件：锁骨下动脉窃血综合征.ppt

After stenting Takaya suarteritis, TA Refers to the aorta and its main branches of the chronic non-specific inflammatory disease. lesions in the aortic arch and its main branches -- the most common； the descending aorta, abdominal aorta, renal artery--secondary Clinical manifestations ①under 40 years, especially women, appear typical signs and symptoms more than one month ②the limb or brain ischemic symptoms ，associated with carotid artery or limb arterial pulse weakened or disappeared；blood pressure reduced, or could not be determined ③ persistent hypertension with abdominal back vascular murmur 1990年美国风湿病学会的分类标准： （1）发病年龄≤40岁 出现症状或体征时年龄40岁 （2）肢体间歇性跛行 活动时一个或更多肢体出现乏力、不适或症状加重，尤以上肢明显 （3）肱动脉搏动减弱 一侧或双侧肱动脉搏动减弱 （4）血压差10mmHg 双侧上肢收缩压差10mmHg （5）锁骨下动脉或主动脉杂音：一侧或双侧锁骨下动脉或腹主动脉闻及杂音 （6）动脉造影异常 主动脉一级分支或上下肢近端的大动脉狭窄或闭塞，病变常为局灶或节段性，且不是由动脉硬化、纤维肌发育不良或类似原因引起 Case discussion Bone group 2012.6.7 History Male ，62 years old A transient syncope Sphygmus ：72 times/min，left--weak Blood pressure ：right arm—110/70 mmHg left arm—70/50 mmHg  Possible diagnosis？ Why ？ Final diagnosis Image impression：Subclavian artery wall calcification , stenosis ； thrombosis can not be excluded Clinical diagnosis ： Subclavian Steal Syndrome (SSS) Subclavian Steal Syndrome Definition ： Subclavian steal syndrome is the proximal subclavian artery or innominate artery obstruction（ caused by a variety of reasons），Subclavian artery distal intraluminal pressure decreased ，ipsilateral blood pressure below the vertebral – basilar arterial pressure --- syphonage ，so result in SSS Clinical manifestations upper limb symptom：Some patients complained of weakness, numbness and pain when the upper limbs exercise Vertebrobasilar insuficiency symptom： Syncope, dizziness, vertigo, standing instability and occipital pain is the most common complaint carotid artery insufficiency symptom： rarely ，but can occur in the patien