Frequency of subclavian steal syndrome in a sample of non-Western population

Abstract

Background

Subclavian steal syndrome (SSS) is not rarely found during ultrasound examinations. Previous reports demonstrated a relation between ethnic factors and SSS. Data regarding SSS in non-Western population are still lacking. We aimed to investigate the frequency of SSS in a sample of Egyptian population.

Methods

In a single-center observational study, we conducted a retrospective analysis of successive patients with competent ultrasound examinations of the brain supplying vessels. The patients presented to our neurovascular laboratory in the context of routine clinical practice.

Results

We enrolled 514 patients in our study. SSS was detected in 9 patients (1.8 %) with a median (IQR) age of 58 (56–63) years. One patient with second-degree SSS received a subclavian stent. Among patients with SSS, 4 patients (44.4 %) had carotid atherosclerosis, 4 patients (44.4 %) had ischemic vascular events in the posterior circulation, and two (22.2 %) had hemodynamically significant carotid stenosis ≥50 %. Using a ROC curve, an interarm SBP (systolic blood pressure) difference of ≥10 mmHg had a sensitivity of 77.8 % and specificity of 66 %, whereas a difference of ≥20 mmHg was associated with a sensitivity of 55.6 % and specificity of 92.4 % for SSS (AUC 0.79, 95 % CI 0.6–0.97, p = 0.004).

Conclusions

SSS is not rare among Egyptian population and should be in mind during ultrasound examination, especially for patient with ischemic events in the posterior circulation and those with significant interarm SBP difference.