Differential Diagnosis for the Causes of Subclavian Steal for Patients With Vascular Access in the Forearm

Subclavian steal phenomenon is normally observed in patients with stenosis of subclavian artery proximal to orifice of vertebral artery(V0). However, uremic patients undergoing hemodialysis using vascular access in the arm or forearm may also develop dialysis associated steal syndrome(DASS).For patients with symptomatic subclavian steal phenomenon, the treatment for these two groups is different. The investigators want to see if the investigators can use noninvasive duplex examination instead of invasive conventional angiography to do the differential diagnosis.

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Key information

Conditions

Subclavian Steal Brain Diseases Brain Ischemia Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Subclavian Steal Syndrome Vascular Diseases Vertebrobasilar Insufficiency

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Mennonite Christial Hospital

Hualien City, Taiwan, 970

About this study

Carotid duplex is widely used for diagnosis of subclavian steal syndrome. We have a patient who suffered from acute brain stem stroke after receiving hemodialysis for months. He has DM related uremia and the vascular access is in the forearm. Subclavian steal was found on duplex in the same arm for hemodialysis. We used standard cuff test for diagnosis of subclavian steal by carotid duplex examination. Accidentally, we found the flow of subclavian artery was back to normal when the cuff is on that stops the flow. We want to see if this phenomenon can be used to serve as a differential diagnostic tool for differentiation of subclavian steal caused by stenosis of subclavian artery or due to DASS.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

patients who revealed subclavian steal in the duplex study

Exclusion criteria

patients who has vascular access in the arm instead of the forearm

Treatment and study plan

carotid duplex

Device

Carotid duplex in the differential diagnosis of subclavian steal syndrome due to Arteriovenous Hemodialysis access in the Ipsilateral arm

Other names: steal syndrome

Primary outcomes

Change of Subclavian Flow to Normal Flow Pattern During Cuff Test

Time frame: two years

we used carotid duplex duplex to study the change of subclavian arterial flow during cuff test to see if there is any difference between normal participants and patients under hemodialysis. There are two patterns seen. One is that the subclavian arterial flow reversed to normal flow pattern during cuff test. The other is that there is no change of subclavian flow pattern when the flow is stopped in the arm by cuff test.
no Change of Subclavian Arterial Flow During Cuff Test

Time frame: one year

we used carotid duplex duplex to study the change of subclavian arterial flow during cuff test to see if there is any difference between normal participants and patients under hemodialysis. There are two patterns seen. One is that the subclavian arterial flow reversed to normal flow pattern during cuff test. The other is that there is no change of subclavian flow pattern when the flow is stopped in the arm by cuff test.
Change of Vertebral Flow to Normal Flow Pattern During Cuff Test

Time frame: two year

we used carotid duplex duplex to study the change of vertebral arterial flow during cuff test to see if there is any difference between normal participants and patients under hemodialysis. There are two patterns seen. One is that the vertebral arterial flow reversed to normal flow pattern during cuff test. The other is that there is no change of vertebral flow pattern when the flow is stopped in the arm by cuff test.
no Change of Vertebral Arterial Flow During Cuff Test

Time frame: 2 years

we used carotid duplex duplex to study the change of vertebral arterial flow during cuff test to see if there is any difference between normal participants and patients under hemodialysis. There are two patterns seen. One is that the vertebral arterial flow reversed to normal flow pattern during cuff test. The other is that there is no change of vertebral flow pattern when the flow is stopped in the arm by cuff test.

Sponsors and collaborators

Lead sponsor

Mennonite Christian Hospital

Other

Registry information

Important dates

Study start: 2010
Primary completion: 2011
Study completion: 2011
First posted: Dec 20, 2010
Registry last updated: Feb 12, 2013

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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