Subcalvian Steal syndrome, what is the diagnostic test?

[medInUSA]

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Subcalvian Steal Syndrome,

what is the best diagnostic test????


Conrad Fisher says: to diagnose with angiography in his book " master the boards step 3"

I just came upon a Qbank Q that said that in the clinical scenario of Subclavian steal (neurological deficits when excercising the arm); the best initial step is to measure the BP in both arms, when the systolic BP difference is greater than 15-20 then the diagnosis is highly probable and you follow up with a duplex ultrasonography to confirm.

 

[zedx]

According the "Textbook of Peripheral Vascular Interventions" it seems like the initial work up would be to look at the BP and then do u/s, however further workup would include the angio.

 

[Scaredshizzles]

Subcalvian Steal Syndrome,

what is the best diagnostic test????


Conrad Fisher says: to diagnose with angiography in his book " master the boards step 3"

I just came upon a Qbank Q that said that in the clinical scenario of Subclavian steal (neurological deficits when excercising the arm); the best initial step is to measure the BP in both arms, when the systolic BP difference is greater than 15-20 then the diagnosis is highly probable and you follow up with a duplex ultrasonography to confirm.

The "best" diagnostic test is probably angiography (or CT-Angiography). BP testing would be the best initial diagnostic test, if you even refer to it as a diagnostic test.

As far as doppler u/s vs. CTA, it probably won't be asked, but if it is asked as next step in management, I would just put the u/s because it is cheaper.

 

[superocker]

Also angio is invasive and duplex ultrasound is not
Best test-angio
COnfirmatory test- duplex(as the next step in MX)