Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report
Ala”a Alhowary,1 Saif Gharaibeh,1 Abdelwahab Aleshawi2 1Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, Jordan; 2Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, JordanCorrespondence: Ala”a Alhowary, Departm...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-06-01
|
| Series: | International Medical Case Reports Journal |
| Subjects: | |
| Online Access: | https://www.dovepress.com/successful-management-of-incidentally-detected-subclavian-stenosis-dur-peer-reviewed-fulltext-article-IMCRJ |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849683026973294592 |
|---|---|
| author | Alhowary A Gharaibeh S Aleshawi A |
| author_facet | Alhowary A Gharaibeh S Aleshawi A |
| author_sort | Alhowary A |
| collection | DOAJ |
| description | Ala”a Alhowary,1 Saif Gharaibeh,1 Abdelwahab Aleshawi2 1Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, Jordan; 2Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, JordanCorrespondence: Ala”a Alhowary, Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110, Jordan, Tel +962791595219, Fax +962 2 7201064, Email alaacom78@yahoo.comBackground: Subclavian artery stenosis is mainly caused by atherosclerotic changes, which may result in ischemic events in the upper limbs and the central nervous system. Other etiological causes include radiation exposure, vasculitis, neurofibromatosis, external compression syndrome, and fibromuscular dysplasia. The conventional anesthetic challenge for these patients is to maintain cerebral perfusion.Case Presentation: We present a case of incidentally discovered left subclavian stenosis in a 65-year-old male who was admitted for spinal surgery. The patient had a history of peripheral arterial disease, diabetes mellitus, and heavy smoking. During the preoperative assessment, the blood pressure readings in the department were within the normal range. In the operating theater, blood pressure readings of the two arms revealed readings of 136/85 mmHg and 235/114 mmHg in the right and left arms, respectively. Accordingly, the operation was postponed for further evaluation of the increased interarm systolic blood pressure difference. Computed tomography angiography revealed focal stenosis at the origin of the left subclavian artery, causing approximately 90% narrowing. The patient underwent a successful subclavian artery angioplasty.Conclusion: It is important to report BP readings of blood pressure in both arms of patients with a history of peripheral arterial disease, heavy smoking, or severe metabolic syndrome. Patients with subclavian stenosis are prone to increased inter-arm systolic blood pressure difference. Accordingly, the bilateral measurement of BP is a simple test with valuable impact on the preanesthetic assessment in an emergency setting.Keywords: general anesthesia, catheterization, peripheral vascular diseases, smoking |
| format | Article |
| id | doaj-art-c9e42fa2ee5642cb9c2dc9becb25ea45 |
| institution | DOAJ |
| issn | 1179-142X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Medical Case Reports Journal |
| spelling | doaj-art-c9e42fa2ee5642cb9c2dc9becb25ea452025-08-20T03:24:00ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2025-06-01Volume 18Issue 1699704103815Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case ReportAlhowary A0Gharaibeh S1Aleshawi A2Department of Anesthesia and Recovery, Faculty of MedicineDepartment of General SurgeryOphthalmologyAla”a Alhowary,1 Saif Gharaibeh,1 Abdelwahab Aleshawi2 1Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, Jordan; 2Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, JordanCorrespondence: Ala”a Alhowary, Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110, Jordan, Tel +962791595219, Fax +962 2 7201064, Email alaacom78@yahoo.comBackground: Subclavian artery stenosis is mainly caused by atherosclerotic changes, which may result in ischemic events in the upper limbs and the central nervous system. Other etiological causes include radiation exposure, vasculitis, neurofibromatosis, external compression syndrome, and fibromuscular dysplasia. The conventional anesthetic challenge for these patients is to maintain cerebral perfusion.Case Presentation: We present a case of incidentally discovered left subclavian stenosis in a 65-year-old male who was admitted for spinal surgery. The patient had a history of peripheral arterial disease, diabetes mellitus, and heavy smoking. During the preoperative assessment, the blood pressure readings in the department were within the normal range. In the operating theater, blood pressure readings of the two arms revealed readings of 136/85 mmHg and 235/114 mmHg in the right and left arms, respectively. Accordingly, the operation was postponed for further evaluation of the increased interarm systolic blood pressure difference. Computed tomography angiography revealed focal stenosis at the origin of the left subclavian artery, causing approximately 90% narrowing. The patient underwent a successful subclavian artery angioplasty.Conclusion: It is important to report BP readings of blood pressure in both arms of patients with a history of peripheral arterial disease, heavy smoking, or severe metabolic syndrome. Patients with subclavian stenosis are prone to increased inter-arm systolic blood pressure difference. Accordingly, the bilateral measurement of BP is a simple test with valuable impact on the preanesthetic assessment in an emergency setting.Keywords: general anesthesia, catheterization, peripheral vascular diseases, smokinghttps://www.dovepress.com/successful-management-of-incidentally-detected-subclavian-stenosis-dur-peer-reviewed-fulltext-article-IMCRJGeneral anesthesiaCatheterizationPeripheral Vascular DiseasesSmoking |
| spellingShingle | Alhowary A Gharaibeh S Aleshawi A Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report International Medical Case Reports Journal General anesthesia Catheterization Peripheral Vascular Diseases Smoking |
| title | Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report |
| title_full | Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report |
| title_fullStr | Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report |
| title_full_unstemmed | Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report |
| title_short | Successful Management of Incidentally-Detected Subclavian Stenosis During Anesthetic Preparation for Spinal Surgery: A Case Report |
| title_sort | successful management of incidentally detected subclavian stenosis during anesthetic preparation for spinal surgery a case report |
| topic | General anesthesia Catheterization Peripheral Vascular Diseases Smoking |
| url | https://www.dovepress.com/successful-management-of-incidentally-detected-subclavian-stenosis-dur-peer-reviewed-fulltext-article-IMCRJ |
| work_keys_str_mv | AT alhowarya successfulmanagementofincidentallydetectedsubclavianstenosisduringanestheticpreparationforspinalsurgeryacasereport AT gharaibehs successfulmanagementofincidentallydetectedsubclavianstenosisduringanestheticpreparationforspinalsurgeryacasereport AT aleshawia successfulmanagementofincidentallydetectedsubclavianstenosisduringanestheticpreparationforspinalsurgeryacasereport |