However, if the cause of subclavian steal syndrome is determined to be atherosclerotic stenosis or occlusion of the proximal subclavian artery, patients should be treated with lifelong antiplatelet therapy to reduce the risk of associated myocardial infarction, stroke, and other vascular causes of death. Here's the breakdown:
If the ischemic symptoms are due to retrograde vertebral artery blood flow, surgical or interventional (ie, angioplasty or stenting) therapy is indicated. The goal is to restore antegrade blood flow in the vertebral artery, thereby alleviating symptoms. This goal can be achieved by restoring adequate perfusion pressure to the affected arm so that collateral blood flow from the head and neck is not required during arm exercise.
Surgical or interventional treatment should not be offered to treat subclavian artery stenosis or occlusion in the absence of symptoms related to either cerebral or ipsilateral arm ischemia. Symptoms (eg, ataxia, dysarthria, diplopia, and muscle cramping in the arm) must be associated with exercise and resolve quickly after cessation of exercise.
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