RESUMO
A study of 132 patients, aged 15 to 40 years, with bilateral scalenus syndrome, accompanied by vertebrobasilar insufficiency, is reported. The diagnostic value was assessed on the basis of 164 angiograms and 408 blood rheologic parameters. Selective arteriography, conducted simultaneously with the compression test and endovascular pressure gradient measurement, yields the most exhaustive and reliable data on the topical cause of the circulatory disturbance within the subclavian artery and its branches. The scalenus syndrome is an important etiologic factor of vertebrobasilar insufficiency. Intermittent flow through the vertebral artery results from ostium compression, spasm or increased flow in one of the vertebral arteries that may be due to an abnormal flexure, local pressure rise or high arcuation of the subclavian arterial segments I and II. Regional disorders of blood rheologic properties are also in evidence. Surgical treatment produces stable good results.