A woman surnamed Lu, nearing fifty, had suffered from dizziness for many years due to dialysis, mistakenly believing it to be an inevitable symptom after dialysis and thus not paying much attention to it. However, more than half a year ago, due to persistently insufficient blood flow during dialysis, she sought help from the Cardiovascular Surgery Department of Yuan Rung Hospital'sLAI CHIN HUChief Physician help, which then uncovered the true cause behind her dizziness.
LAI CHIN HUChief PhysicianInitial examinations revealed that Ms. Lu's axillary vein was stenosed, affecting the patency of her dialysis fistula. Therefore, she first underwent balloon angioplasty. Although the fistula was opened, her arterial pressure remained very low, and blood flow was very weak. Upon further questioning by Dr. Lai, Ms. Lu mentioned that she usually felt dizzy, and the more active she was, the more severe the dizziness became. This crucial clue led LAI CHIN HUChief Physician to highly suspect that she was suffering from the rare "subclavian steal syndrome".
Subsequent angiography confirmed LAI CHIN HUChief Physician's suspicion, with images showing that the opening of Ms. Lu's subclavian artery was almost completely blocked. For this, the team arranged a second catheter-based minimally invasive vascular treatment, first using a guidewire to pass through the blockage, then expanding it with a balloon, and finally, because the vessel still had some calcification and stenosis, a stent was inserted to fully open it, completely resolving the vascular obstruction problem.
LAI CHIN HUChief Physicianexplained that when the subclavian artery is blocked, the blood supply to the arm is insufficient, and the body activates a compensatory mechanism to "steal" blood from the vertebral artery, which supplies the brain, for use by the left arm. When arm activity increases, more blood is stolen, reducing the blood supply to the brain, which in turn leads to dizziness. He specifically reminded that if the blood pressure difference between both arms exceeds 30 mmHg, accompanied by symptoms of arm weakness or dizziness, people should seek medical attention as soon as possible.
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