Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Evaluation of neurosonography for a case of brainstem transient ischemic attack (TIA) due to proximal subclavian artery stenosis, with favorable outcome after axillo-axillary bypass grafting

Nozomu Matsuda1), Yutaka Matsuura1), Tomoko Soeta1), Ken Shibano1), Kazuhiro Endo1), Yoshiyuki Sato2), Koki Takahashi2), Hitoshi Yokoyama2), Teiji Yamamoto1)

1)Department of Neurology, Fukushima Medical University
2)Department of Cardiovasuculosurgery, Fukushima Medical University

We report an 82-year-old man with crescendo brainstem TIA and left upper-limb ischemia due to the left proximal subclavian artery stenosis. Angiography revealed that the left proximal subclavian artery was stenotic. The right vertebral artery was considered to be aplastic or occlusive. Neurosonography, especially the echo-Doppler study of the left vertebral artery, showed that the subclavian artery steal phenomenon did not occur. This study has enabled us to opt for axillo-axillary bypass. We preferred to avoid percutaneous transluminal angioplasty in order to avoid the risk of embolization. The patient received the axillo-axillary bypass operation. He has been free of TIAs and the left upper-limb ischemia since the surgery. We have evaluated his blood circulation fully, by comparing his state before and after the axillo-axillary bypass grafting.

(CLINICA NEUROL, 45: 372|375, 2005)
key words: subclavian artery stenosis, transient ischemic attack, axillo-axillary bypass, neurosonography

(Received: 6-Aug-04)