A number of studies are available. the noninvasive options would be pulse volume recording and ultrasound which would determine the objective differential pressure at various levels and reveal the level of occlusion. Next step would be CTA or angiography. Its important to determine if you have clots or occlusion and where it came from as this could occur elsewhere
Best of luck
Thank you for your reply - so I assume you do advocate a follow-up. I am seeing my PCP tomorrow for follow-up due to viral respiratory infection that started 2/1. That past few days I have notice black streaks under the distal nailbed - ? vasculitis..
My other concern was on 2/21 when I returned to work after illness, L 83/63 R 146/69 BP stayed elevated 2 days (L97/60 R 159/88) and then came back down today L86/52, R 124/60. The only connection I could make was a sinus arrythmia (HR 85-95) at time of increased Rt. BP.
I hope my PCP will take this seriously. I have read that a difference is not unusual but the range given is listed as less than 30. Thank you again for your imput.
There are a number of causes of extremity occlusion in the axillary, subclavian or brachial artery. You should be referred to a vascular specialist, in this case vascular surgeon, to own the problem, take you serious and determine appropriate management
Best of health
I saw a vascular surgeon today who did doppler color ultrasound.....yes, left vertebral artery is very tortuous, blood flow going both directions and said I have subclavian steal syndrome. He also was able to look on Synapse my 1-1/2 yr old films MRA/MRi from when I had drop attacks and TIA (looked okay) and my CT Angio done last week and that showed the stenosis. He found site of left subclavian artery stenosis further out (distally) than the normal stenotic sites.
Since I am already taking ASA, nothing more to do at this time unless I become symptomatic with arm fatigue, claudication, etc. Then a balloon procedure might be indicated. Just have to remind people to take BP only in the right arm, not the left, and for me to do my own monitoring as for now right systolic does fluctuate between 120-160. No antihypertensives would be needed unless I sustain high readings.
Thank you again for your interest and comments. They were greatly appreciated. And yes, PCP did take me seriously especially after she took BP L 90 systolic, R 156 systolic and requested I see vascular surgeon.