Atypical presentation of subclavian steal syndrome mimicking transient ischemic attack: successful endovascular management with angiographic correlation—a case report
- 1Neurology Department, Yancheng Clinical College of Xuzhou Medical University
Abstract
Background Subclavian steal syndrome is an uncommon vascular disorder caused by stenosis or occlusion of the subclavian artery proximal to the vertebral artery origin. It classically presents with vertebrobasilar symptoms such as vertigo, syncope, or diplopia; however, atypical transient neurological presentations may delay diagnosis. Case presentation A 71-year-old patient presented with recurrent slurred speech and left upper limb weakness without vertigo or diplopia. Examination revealed absent measurable blood pressure and absent radial pulse in the left arm, carotid bruits, and mild distal left upper limb weakness. Computed tomography angiography and digital subtraction angiography demonstrated severe left subclavian artery stenosis with collateral circulation consistent with subclavian steal physiology. The patient underwent successful percutaneous transluminal balloon angioplasty and stenting. Post-stenting angiography confirmed restored antegrade flow without residual steal phenomenon, and the neurological and limb symptoms improved after revascularization. Conclusions This case emphasizes that subclavian steal syndrome can mimic transient ischemic attack and may present without classic vertebrobasilar symptoms. Careful vascular examination, early vascular imaging, and timely endovascular management are important to prevent diagnostic delay and improve clinical outcomes.
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BibTeX
@article{maqbool2026atypical,
title = {{Atypical presentation of subclavian steal syndrome mimicking transient ischemic attack: successful endovascular management with angiographic correlation—a case report}},
author = {Hamza Maqbool and Gao Yang and Asmat Ullah and Xiaofeng Qu and Ren Taojie and Wei Lijun and Yajie Wang},
journal = {Journal of Medical Case Reports},
year = {2026},
month = jul,
doi = {10.1186/s13256-026-06418-9},
url = {https://doi.org/10.1186/s13256-026-06418-9},
note = {CC BY},
}
RIS
TY - JOUR
TI - Atypical presentation of subclavian steal syndrome mimicking transient ischemic attack: successful endovascular management with angiographic correlation—a case report
AU - Hamza Maqbool
AU - Gao Yang
AU - Asmat Ullah
AU - Xiaofeng Qu
AU - Ren Taojie
AU - Wei Lijun
AU - Yajie Wang
PY - 2026
DA - 2026/07/01
JO - Journal of Medical Case Reports
DO - 10.1186/s13256-026-06418-9
UR - https://doi.org/10.1186/s13256-026-06418-9
AB - Background Subclavian steal syndrome is an uncommon vascular disorder caused by stenosis or occlusion of the subclavian artery proximal to the vertebral artery origin. It classically presents with vertebrobasilar symptoms such as vertigo, syncope, or diplopia; however, atypical transient neurological presentations may delay diagnosis. Case presentation A 71-year-old patient presented with recurrent slurred speech and left upper limb weakness without vertigo or diplopia. Examination revealed absent measurable blood pressure and absent radial pulse in the left arm, carotid bruits, and mild distal left upper limb weakness. Computed tomography angiography and digital subtraction angiography demonstrated severe left subclavian artery stenosis with collateral circulation consistent with subclavian steal physiology. The patient underwent successful percutaneous transluminal balloon angioplasty and stenting. Post-stenting angiography confirmed restored antegrade flow without residual steal phenomenon, and the neurological and limb symptoms improved after revascularization. Conclusions This case emphasizes that subclavian steal syndrome can mimic transient ischemic attack and may present without classic vertebrobasilar symptoms. Careful vascular examination, early vascular imaging, and timely endovascular management are important to prevent diagnostic delay and improve clinical outcomes.
SN - 1752-1947
ER -