Case 2

Subclavian Steal Syndrome

Procedure
Angioplasty and Stent of Left Subclavian Artery via Radial Artery
Approach
54 year old female with 3-4 weeks
progressive headache and dizziness,
exacerbated by left arm activity such
as housecleaning

30mm Hg blood pressure discrepancy
between arms
5 Fr Terumo Glidesheath
0.018 V18 Control microwire (300cm)
Sterling OTW BDC 6mm x 20mm
Stent: 2 x Abbott Xpert 8mm x 30mm
Closure: manual compression


Devices
Fusion of diagnostic CTA and 10sDynaCT
(non-contrast) based on anatomical skeletal
landmarks

Result - 3D Roadmap using CTA

iGuide toolbox markers showing origin of left
vertebral and left subclavian, overlaid to live
fluoro



Imaging Technique
Pre-Treatment CTA
Radial Approach
Chicago live transmission: WLNC Istanbul
Chicago live transmission: WLNC Istanbul
Chicago live transmission: WLNC Istanbul
3D CT Overlay for Contrast Less Surgery
3D Markers Showing Aorta & Vert. Art.
Angioplasty Using Overlay Guidance
Post Stent Placement
12 month Follow-up CTA Neck