Subclavian artery. Syndrome of the subclavian artery

The subclavian arteries are vessels, they carry blood to the upper limbs of the human body. This article will discuss in detail all the basic concepts on this topic. You will learn what is the syndrome of the subclavian artery and what features of its treatment exist.

What is the subclavian artery?

The circulatory system is a complex intricacies from various veins, arteries, and capillaries. A large paired vessel, receiving blood from the aortic arch - subclavian artery - refers to the vessels of a large circle of the human blood circulation. It supplies blood to the occipital parts of the brain, the cerebellum, the neck part of the spinal cord, muscles and parts of the neck, the shoulder girdle and upper limb, as well as some parts of the chest and abdominal cavity.

Topography of the subclavian artery

What does the word "topography" mean? This is a literal finding or location of something about some objects. Let us consider in more detail what the topography of the subclavian artery means, in other words, where and relative to what it is located. It originates from one side of the brachiocephalic trunk, and on the other - from the arch of the aorta, bypasses the apex of the lung and exits through the opening of the thorax from above. In the neck area, the subclavian artery is seen next to the brachial plexus and is on the surface. This arrangement of the vessel allows it to be used to stop possible bleeding or the injection of medications. Further, the subclavian artery bends through the rib, passes under the clavicle and enters the armpit, where it becomes axillary. Then, after passing the armpit, she goes to her shoulder. The name of this site is the brachial artery. In the area of the elbow joint, it diverges into the radial and ulnar arteries.

Catheterization of the subclavian vein. Puncture

As already mentioned above, the subclavian vein (and the artery, too) lie on the neck on the neck. It is this place that is used for taking a puncture, inserting a catheter. What is the reason for choosing this particular part of the vessel? There are several criteria for this choice:

1. Anatomical accessibility.
2. Stability of position and diameter of a lumen.
3. Sufficient or significant size (diameter).
4. The velocity of blood flow exceeds the velocity of blood in the veins of the limbs.

Based on the data outlined above, the catheter placed in the vein will almost touch the walls of the artery. Medical drugs that are injected through it will quickly reach the right atrium and ventricle, they contribute to an active effect on hemodynamics. Entered into the subclavian vein drugs are very quickly mixed with the blood, while not irritating the interior of the artery. In some cases, there are contraindications for puncture and insertion of a catheter.

Left and right subclavian artery

This vessel is a paired organ, as already mentioned above: the right subclavian artery and the left one. The first is the final branch of the brachiocephalic trunk, as far as the left one, it leaves the arch of the aorta. In addition, the latter is about 4 cm longer than the first. The right subclavian artery delivers blood to certain sections of the right arm, supplies it with the head and thorax. The left subclavian artery carries the fluid carrying important substances for life support to the left arm.

The main departments of the subclavian artery

The left and right subclavian artery are divided purely conditionally into three main departments, or a site:

1. From the place of formation of the subclavian artery to the entrance to the interstitial space.
2. Division, which is confined to the interlace space.
3. At the exit from the interstitial space to the armpit.

Branches of the first subclavian artery

This part of the article will tell a little about how the subclavian artery and its branches look, that is, on which parts the jar is branched. From its first section (the space between the entrance to the interstitial gap and the beginning of the artery) several branches branch out, here are the main ones:

1. Vertebral artery, paired. It passes through the transverse process of the sixth cervical vertebra. Further, it rises top and falls into the cavity of the skull through the nape, that is, through its opening. Then it connects to the same artery of the other side, thereby forming a basilar artery. What is the function of the vertebral artery? This vessel supplies blood to the spinal cord, solid occipital lobes of the brain and muscles.
2. The internal thoracic artery begins on the lower part of the subclavian artery. The canal supplies blood to the thyroid gland, diaphragm, bronchi, sternum, etc.
3. Shield shaft. It originates near the inner edge of the staircase, reaches a length of about 1-2 cm. The sciatic trunk is divided into branches that supply blood to the muscles of the scapula and neck, and also the larynx.

Branching of the second and third subclavian artery

The second section of the subclavian artery, bounded by the interstitial space, has only one branch, called the rib-cervical trunk. It begins at the back of the subclavian artery and divides into several branches:

1. The highest intercostal artery (from this artery, the posterior branches leading to the back muscles).
2. Spinal vessels.
3. Deep neck cervical artery.

The third department of the subclavian artery also has one branching - this is the transverse artery of the neck. It permeates the humiliation of the shoulder and is divided into:

1. A superficial artery that supplies blood to the spinal muscles.
2. Dorsal artery of scapula. She descends to the wide back muscle, nourishes it and the small muscles next to it.
3. Deep branch of the subclavian artery .

Here, such concepts as the subclavian artery and its branches are described in sufficient detail, additional information can be obtained from the medical literature.

Possible diseases of the subclavian artery

The main disease that affects the subclavian artery and its branches is the constriction of the lumen of the vessels, in other words, stenosis. The main cause of this ailment is atherosclerosis of the subclavian artery (deposition of lipids on the walls of blood vessels) or thrombosis. This disease is most often acquired, but there are cases of the congenital. Risk factors for atherosclerosis of the subclavian artery are:

1. Arterial hypertension.
2. Smoking.
3. Excess weight, obesity.
4. Diabetes mellitus and some other diseases.

The most common cause of stenosis of the subclavian artery is a metabolic disorder in the human body, neoplasms and inflammatory processes. Strong stenosis leads to a decrease in blood flow to the vital organs of man, there is a deficit of oxygen and nutrients in the tissues. In addition, stenosis can cause ischemic disease, in particular stroke.

Syndrome of the subclavian artery

Insufficient blood flow can be caused not only by an impediment to blood flow due to occlusive-stenotic lesions, but also by vertebral-subclavian "stealing". This subclavian artery syndrome, or style-syndrome, develops in the event of stenosis or occlusion in the first compartment of the vessel. Simply put, the blood in the subclavian canal does not come from the aorta, but from the vertebral artery, which can lead to cerebral ischemia. The maximum manifestations of this disease cause physical stress on the upper limb.

Symptoms of the disease:

1. Dizziness.
2. Prescensory conditions.
3. Impairment of vision.
4. Muscular weakness on the side of the lesion.
5. Attenuation or complete absence of pulse on the side of the lesion.

More information about stenosis of the subclavian artery

The deposits on the walls of the vessels leading to the constriction of the latter have a lipid basis, that is, in fact they are the derivatives of cholesterol. These deposits can narrow the lumen of the vessel to 80%, sometimes even completely clog it. In addition to the above factors that cause stenosis of the subclavian artery, there are others, such as:

1. Irradiation.
2. Arteritis.
3. Compression syndromes.
4. Various lesions, such as fibro-muscular dysplasia, etc.

Very often in people suffering from stenosis of the subclavian artery, the remaining vessels are affected. These can be coronary canals, that is, cardiac channels, and carotid canals - arteries of the lower extremities. Basically, with such a pathology as constriction of the lumen of the vessels, the left subclavian artery is affected. According to statistics, this happens several times more often than with the right one.

Symptoms of stenosis:

1. Weakness in muscles.
2. Feeling tired.
3. Pain in the upper limbs.
4. Necrosis of the fingers.
5. Bleeding in the nail area.

In addition, neurological symptoms may appear, that is, "stealing" occurs: blood is redirected from normal vessels to the affected area. Symptoms of neurological diseases:

1. Visual impairment.
2. Loss of consciousness.
3. Violation of speech.
4. Loss of balance.
5. Dizziness.
6. Loss of sensitivity in the face.

How to treat stenosis of the subclavian artery?

Treatment of stenosis can be medicamentous, surgical and interventional. The main methods of therapy are X-ray endovascular stenting of the subclavian artery and sleepy subclavian shunting. The latter method is recommended for people with hypersthenic physique, in which it is difficult to distinguish the first section of the artery. This method of treatment is also recommended for stenosis in the second section of the subclavian artery.

Stenting of the subclavian artery

Stenting is the treatment of the subclavian artery through a small incision on the skin, 2-3 mm in length, made by means of a puncture hole. This method of therapy has several advantages over surgical intervention, as it causes less injuries and discomfort. In addition, it is the most sparing and organ-preserving method of treatment, in which the subclavian artery remains in its original form, which is very important for the patient.

The procedure of stenting is practically painless and is under local anesthesia. This operation allows to increase the lumen of the vessels with the use of special catheters and stents in the form of cylinders. The latter is a cylindrical endoprosthesis cut out by a laser from a single metal tube. This device is attached to a special balloon catheter and compressed in the subclavian artery. When the stent reaches the vessel constriction zone, some control procedures are performed, related to its proper location. After this, the device is opened under high pressure. If the stent is not sufficiently opened, angioplasty of the stented area is performed by a special catheter with a can on the end for optimal achievement of the result. To date, it is possible to perform this operation for free, you can do it by obtaining a federal quota. The patient with a similar disease must consult a doctor in charge.

Possible risks with stenting

The procedure for stenting the subclavian artery lasts about 2 hours. This operation is performed in the cardiac catheterization department. After stenting, if necessary, pain medications are taken, since painful sensations may appear in the place where the subclavian artery and tissues have been incised. Complications after this procedure are very rare, as the patient before it undergoes thorough preparation and supervision. But still some unpleasant consequences can arise, it is:

1. Allergy to medications.
2. Reaction to anesthetics.
3. Minor bleeding at the point of incision.
4. Temperature.
5. Headache.
6. Infection.
7. Air embolism.
8. Damage to the wall of the artery or aorta.
9. Subclavian artery thrombosis.
10. Migration of the stent.
11. Neurological complications, etc.

Interventional treatment of stenosis of the subclavian artery by balloon angioplasty and stenting is a modern, minimally invasive and effective therapy. They have very short periods of postoperative period and hospitalization.