ASSESSMENT OF STEAL SYNDROMES WITH COLOR AND PULSED DOPPLER IMAGING

The purpose of this study was to assess the incidence of and determine the types of steal phenomena occurring in the extracranial arteries o f the head (common carotid artery [CCA], internal carotid artery [ICA] , external carotid artery [ECA], vertebral artery [VA] and ophthalmic artery [OA]). A total of 3759 extracranial carotid artery sonographic examinations (7518 carotid arteries) of consecutive patients were revi ewed. In every case an attempt was made to also evaluate the vertebral arteries. Reverse flow was found in 37 arteries in the examined regio ns in 36 patients. One of the most common findings was reversed flow i n one of the VA as a sign of subclavian steal syndrome. This occurred in 17 cases (0.22%). The OA was examined in 15 cases when occlusion of the ICA was found in the neck region. In 14 (93.3 %) of these cases t he flow in the OA proved to be reversed. In 4 cases of occlusion of th e CCA (0.05 %) the ICA was fed through the-main branch of the ECA, in which the flow was reversed. More rarely, in 2 cases (0.027 %) both th e CCA and ICA were occluded, and the main branch of the ECA was suppli ed through its dilated side branch, in which the flow direction was re versed. Colour and pulsed Doppler imaging are appropriate noninvasive methods for imaging these steal syndromes. Their diagnosis cannot only explain clinical signs, but can also lead to therapeutic consequences .