Diagnostic Role of Doppler Ultrasound in Innominate Steal Syndrome: A Case Presentation

Abstract

Innominate steal syndrome is a rare clinical finding, caused by steno-occlusive damage of innominate artery leading tocerebrovascular symptoms. Doppler ultrasound is a valuable noninvasive method for examination of innominate artery. We report a case of a 68-year-old man who presented with recurrent blurred vision, dizziness, headache, syncopal episodes, and pain in right arm during physical activity. Arterial blood pressure was not measured and diminished radial pulse was detected in the right arm of the patient. We used a duplex ultrasound Doppler for examination of extracranial arterial vessels. Our findings were reversed flow in the right vertebral artery and systolic decelerationand tardus–parvus waveform in the right carotid artery. The feature angiographic evaluation revealed 90% stenosis of the innominate artery. Endovascular stenting was applied to the patient and enabled normal antegrade flow in the right common carotid and vertebral artery. Duplex Doppler ultrasound is a non-invasive and fairly effective method for detection steno-occlusive atherosclerotic diseases of extracranial arterial system. Here, critical stenosis in the innominate artery was successfully detected by Doppler ultrasonography and confirmed by angiographic examination.