Totally Occluded Subclavian Artery

[JMTS]

My story is an unusual one.  It was discovered the the blood pressure between my two arms was vastly different (by as much as 55 points between my left and right arms, with the pressure in my left arm lower).  I had the following tests conducted:  Cardiolite Stress Test, Echocardiagram, peripheral artery studies, and arteriogram.  The Cardiolite Stress Test and Echocardiagram were both normal.  The peripheral artery studies showed the discordant pressure between my two arms, and my arteriogram showed 100% blockage of my left subclavian artery.  I had the arteriogram done because I was supposed to get a stent placed in my left subcalvian artery; however, once the doctor saw that it was 100% blocked, he decided against the procedure and referred me to a surgeon who specializes in heart diseases (he is board certified in vascular, thoracic, and cardiology).  So, yesterday I spoke with the surgeon who told me NOT to have bypass surgery to correct my blocked left subclavian artery, stating that since I did NOT have subclavian steal syndrome and that my arm was not swollen or going numb, that it was obvious to him that I had had this blockage for some time (I do agree with this and also feel that it may even be congenital, which he also said was a strong possiblilty) and that my body had compensated over the years by making other pathways. He assured me that the blockage would not break lose and throw a clot; he told me that what was in the blockage was "like concrete" and that the interventional cardiologist couldn't have gotten a stent in place if he wanted to.  So, do I need to get a second opinion on this?  It seems odd and strange to me that I can continue on with my left subclavian artery blocked 100%.  I was relieved to hear that I would not have to have bypass surgery, yet, on the other hand, I was concerned about walking around with this blockage in my body.  Any ideas would be most welcome.
Jan

[WilliamET]

Did you ever get that surgery Emariesan?  How are things with you?

[Emariesan]

Can anyone help me?  I have a 7 cm blockage in my right subclavian, and I do have symptoms.  My right arm is very painful, to weak to stir a pitcher of iced tea without switching to my left hand.  I am right handed, and everything is so difficult.  The vascular surgeon told me it was basically inoperable, because there was a good chance I would stroke out on the table. He s
also compared my blockage to cement, and suspects it is congenital. He advised me to become left handed--seriously.  I'm 38 years old. He says even if I got the specialist in Cleveland to do it, it would take several surgeons, and if it doesn't work, there is no going back, I lose the arm--if I live through it. Then at least two months off work.  I cant live like this for the rest of my life though.  Any suggestions?

[onenerveleft]

I do have subclavian steal syndrome, 100% blockage... I have already had a heart triple by pass plus two stents.  I've spent the last 3-4 years trying to find WHY my left arm has been decreasing in size, hardly any BP detected in left arm,  fingernails are becoming yellowed and had to have two removed as they started turning black and infected, now vision sometimes blurred; I have never had to wear glasses so my eyes have been great until lately.
This past month, after Doppler tests, chemical stress test, etc.,etc., several doctor visits... they have decided surgery needs to be done, would have to be a bypass, tho risky due to my other heart issues... now waiting for the surgery to be scheduled.  I feel I don't have much choice, and I have had second opinion, but my heart doctor had to sign off on it... he did, after he explained all the risks....really put me thur the drill as far as more tests, scans than I ever had.   Thank you, onenerveleft

[JMTS]

Thank you for your repsonse.  It is reassuring that others are dealing with similar types of problems where the diagnosis is "do nothing" other than eat healthy and exercise.  My body, historically, has numerous anamolies.  Everytime time I have had surgery, something "strange" has surfaced insofar as a congenital anamoly.  I am in the medical books twice!  So, this really should come as no surprise to me.  Best wishes to you.
Jan

[JMTS]

Many thanks for your post.  Yes, collateral vessels have developed providing me with a natural bypass as well.  I am thankful not to have to go through bypass surgery and will continue on, "business as usual", with my life.  I have always been active and eat right, so something must be in my favor.  Best to you.
Jan

[kenkeith]

helpful.  Strangely, my comments were posted before I finished????  Am I being told I am out-of-time or something? :)

[kenkeith]

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QUOTE: So, yesterday I spoke with the surgeon who told me NOT to have bypass surgery to correct my blocked left subclavian artery, stating that since I did NOT have subclavian steal syndrome and that my arm was not swollen or going numb, that it was obvious to him that I had had this blockage for some time (I do agree with this and also feel that it may even be congenital, which he also said was a strong possiblilty) and that my body had compensated over the years by making other pathways. He assured me that the blockage would not break lose and throw a clot; he told me that what was in the blockage was "like concrete" and that the interventional cardiologist couldn't have gotten a stent in place if he wanted to.  So, do I need to get a second opinion on this?  It seems odd and strange to me that I can continue on with my left subclavian artery blocked 100%.
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First known 4 years ago that I had had a 100% blocked LAD, but collateral vessels had developed providing a natural bypass.

LAD is the main coronary artery for the left side of the heart, and the blockage is little higher than mid-way.  No surgery was recommended and medication exercise, diet, etc. for CAD mitral valve insuffiency serves well...no symptoms and I feel fine for the last 4 years, not even a bout with the common cold. A well compensated can be very very

[maggiemag]

Jan, I agree that it probably would be a congenital thing, and not really a *blockage* per se.  Plus if the only symptom you have is discordant BP's, then I surely wouldn't go for invasive surgery. You might want to go for a second opinion for more peace of mind, though.
I have something a little bit similar, in that I have congenital messed up subclavians as well, but mine is described as *aneurysmal dilitations* as the most prominent defect.  I walked around for a couple of months thinking I had an aneurysm that could blow at any time.  No one actually told me not to ever worry about that.  Since I am an RN, I think they figured that I just knew that it isn't an actual aneurysm, but just an anomaly.  In any event, I just don't even think about it, except that the defects caused the EP to not be able to implant an ICD when they decided I needed one.  Just be sure that you include your info whenever you are asked to give your medical history.  I think you will be fine, although I am not a doctor!