Differential Diagnosis for the Causes of Subclavian Steal for Patients With Vascular Access in the Forearm

Differential Diagnosis for the Causes of Subclavian Steal for Patients With Vascular Access in the Forearm

Sponsors

Lead Sponsor: Mennonite Christian Hospital

Source Mennonite Christian Hospital
Brief Summary

Subclavian steal phenomenon is normally observed in patients with stenosis of subclavian artery proximal to orifice of vertebral artery(V0). However, uremic patients undergoing hemodialysis using vascular access in the arm or forearm may also develop dialysis associated steal syndrome(DASS).For patients with symptomatic subclavian steal phenomenon, the treatment for these two groups is different. The investigators want to see if the investigators can use noninvasive duplex examination instead of invasive conventional angiography to do the differential diagnosis.

Detailed Description

Carotid duplex is widely used for diagnosis of subclavian steal syndrome. We have a patient who suffered from acute brain stem stroke after receiving hemodialysis for months. He has DM related uremia and the vascular access is in the forearm. Subclavian steal was found on duplex in the same arm for hemodialysis. We used standard cuff test for diagnosis of subclavian steal by carotid duplex examination. Accidentally, we found the flow of subclavian artery was back to normal when the cuff is on that stops the flow. We want to see if this phenomenon can be used to serve as a differential diagnostic tool for differentiation of subclavian steal caused by stenosis of subclavian artery or due to DASS.

Overall Status Completed
Start Date August 2010
Completion Date July 2011
Primary Completion Date July 2011
Phase N/A
Study Type Interventional
Primary Outcome
Measure Time Frame
Change of Subclavian Flow to Normal Flow Pattern During Cuff Test two years
no Change of Subclavian Arterial Flow During Cuff Test one year
Change of Vertebral Flow to Normal Flow Pattern During Cuff Test two year
no Change of Vertebral Arterial Flow During Cuff Test 2 years
Enrollment 16
Condition
Intervention

Intervention Type: Device

Intervention Name: carotid duplex

Description: Carotid duplex in the differential diagnosis of subclavian steal syndrome due to Arteriovenous Hemodialysis access in the Ipsilateral arm

Other Name: steal syndrome

Eligibility

Criteria:

Inclusion Criteria: - patients who revealed subclavian steal in the duplex study Exclusion Criteria: - patients who has vascular access in the arm instead of the forearm

Gender: All

Minimum Age: N/A

Maximum Age: N/A

Healthy Volunteers: No

Overall Official
Last Name Role Affiliation
lingchih wu Principal Investigator Mennonite Christian Hospital
Location
Facility: Mennonite Christial Hospital
Location Countries

Taiwan

Verification Date

February 2013

Responsible Party

Type: Principal Investigator

Investigator Affiliation: Mennonite Christian Hospital

Investigator Full Name: Ling-Chih, Wu

Investigator Title: doctor

Keywords
Has Expanded Access No
Condition Browse
Number Of Arms 2
Arm Group

Label: carotid duplex for hemolytic patients wtih SSS

Type: Active Comparator

Description: assigned intervention:carotid duplex

Label: carotid duplex for nonhemolytic patients with SSS

Type: Active Comparator

Study Design Info

Allocation: Non-Randomized

Intervention Model: Parallel Assignment

Primary Purpose: Diagnostic

Masking: None (Open Label)

Source: ClinicalTrials.gov