[Subclavian steal syndrome: a report of 25 cases].

From 1982 to 1992, 25 patients with subclavian steal syndrome (SSS) were admitted with 20 undergoing surgery. Etiology included atherosclerosis 56% (14/25), Takayasu's disease 36% (9/25), 14 of them were smokers. Stenosis or occlusion of the left subclavian artery were found in 14, the right in 7, and bilateral in 4. 14 cases had vertigo symptoms, 24 cases had claudication of the arm, 9 of them complained transient ischemic attack (TIA). Carotid to subclavian bypass were performed for 15 cases. Two patients underwent axilloaxillary bypass with evidence of both clinical and laboratory improvement. Aorta-Carotid graft bypass was done in 2 cases with good result in one. PTA was done for a girl with innominate severe stenosis but symptom recurred three months later. Symptoms of the upper extremity ischemia were relieved in 75% of the patients, and of the cerebrovascular ischemia in 50%. Our conclusion is that surgical therapy remains the treatment of choice in symptomatic patients.