Ozen et al. Surgical procedures in subclavian steal syndrome: A retrospective analysis Journal-Cardiovascular Surgery 2015:3(1):4-7 doi; 10.5455/jcvs.2015315 Original Research 4 Surgical procedures in subclavian steal syndrome: A retrospective analysis Anil Ozen 1 , E. Utku Unal 1 , Emre Kubat 2 , Aytac Caliskan 1 , Basak Soran 1 , Erman Kiris 1 , Ayşen Aksoyek 1 , C. Levent Birincioglu 1 1 Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Hospital,Ankara, Turkey, 2 Department of Cardiovascular Surgery, Karabük Training and Research Hospital, Karabük, Turkey *Correspondence Author: Department of Cardiovascular Surgery, Karabuk Training and Research Hospital, Sirinevler Mah., Alpaslan Cad. No:1, 78200 Merkez/Karabuk, Turkey Tel: +905336992600, e-mail: ekuba@gmail.com Key words: Subclavian steal syndrome; vascular surgical procedures; suclavian artery Received: 05.12.2014 Accepted: 06.01.2015 e-published: 18.01.2015 Abstract Objectives: Patients diagnosed with subclavian steal syndrome present with claudication in the upper extremity, vertigo, blurred vision, dizziness and myocardial ischemic symptoms after coronary artery bypass grafting. Surgery is still a good option with good long-term patency rates and symptom-free survival. We aimed to present our results on surgery for subclavian steal syndrome. Materials and Methods: This study is a retrospective study involving 16 patients undergoing surgery for subclavian steal syndrome from January 2005 to December 2012. Postoperative follow-up consisted assessment of graft patency and resolution of symptoms. Results: There was only 1 in-hospital mortality. The mean follow up period was 28.58 ± 26.92 months. Nine patients were symptom-free. Doppler ultrasonographic examination of 11 patients revealed patent grafts. Conclusion: Choice of surgical procedure in subclavian steal syndrome depends on the patient characteristics and the preference of the surgeon. Surgical procedures are safe and durable in patients with subclavian steal syndrome who are not eligible for angioplasty. Consideration of the age, stenosis and comorbidities will aid making the correct surgical strategy with satisfactory long-term results. Introduction Stenosis or occlusion of the proximal part of the sub- clavian artery causes a steal phenomenon from the ipsilat- eral vertebral artery. Patients present with different types of symptoms. One is claudication in the upper extremity that arises from stenosis and occlusion. Other one is verte- brobasilar insuffciency symptoms such as vertigo, blurred vision, dizziness and sometimes transient ischemic attacks as a result of steal phenomenon [1]. Patients with coronary artery bypass grafting (CABG) may present with symptoms of myocardial ischemia due to steal of blood from the inter- nal thoracic artery to the subclavian artery and cerebral cir- culation [2]. Smoking is the most common risk factor (74%) followed by hypertension (42%), coronary artery disease (30%), hyperlipidemia (17%) and diabetes mellitus (8%) [3]. Aortic arch aortography, computed tomography angiography (CTA) or magnetic resonance imaging demonstrates the stenotic segment. It is also possible to see the retrograde fow in the vertebral artery by color Doppler ultrasonography [4]. Nowadays, suitable lesions can be treated by endovascular techniques. Nevertheless, surgery is still a good option with good long-term patency rates and symptom-free survival [1]. In this study, 16 patients undergoing surgery for subclavian steal syndrome were evaluated retrospectively. Materials and Methods A total of 16 patients who underwent surgery for subcla- vian steal syndrome in our hospital between January 2005 and December 2012 were involved in this study. The patient fles were collected, and demographic data, as well as oper- ative characteristics, were recorded. The Hospital Ethics Committee approved the study based on retrospective data retrieval, waiving for individual consent. This study com- plies with the Declaration of Helsinki.