The DOI matches its Crossref record.
The subclavian steal phenomenon: A common vascular disorder with rare neurologic deficits
Abstract
This study aimed to quantify core surgical trainee (CST) differential attainment (DA) related to three cohorts; white UK graduate (White UKG) versus black and minority ethnic UKG (BME UKG) versus international medical graduates (IMGs). The primary outcome measures were annual review of competence progression (ARCP) outcome, intercollegiate Membership of the Royal College of Surgeons (iMRCS) examination pass and national training number (NTN) selection. Intercollegiate Surgical Curriculum Programme (ISCP) portfolios of 264 consecutive CSTs (2010–2017, 168 white UKG, 66 BME UKG, 30 IMG) from a single UK regional post graduate medical region (Wales) were examined. Data collected prospectively over an 8-year time period was analysed retrospectively. ARCP outcomes were similar irrespective of ethnicity or nationality (ARCP outcome 1, white UKG 60.7% vs BME UKG 62.1% vs IMG 53.3%, p=0.395). iMRCS pass rates for white UKG vs BME UKG vs IMG were 71.4% vs 71.2% vs 50.0% (p=0.042), respectively. NTN success rates for white UKG vs BME UKG vs IMG were 36.9% vs 36.4% vs 6.7% (p=0.023), respectively. On multivariable analysis, operative experience (OR 1.002, 95% CI 1.001 to 1.004, p=0.004), bootcamp attendance (OR 2.615, 95% CI 1.403 to 4.871, p=0.002), and UKG (OR 7.081, 95% CI 1.556 to 32.230, p=0.011), were associated with NTN appointment. Although outcomes related to BME DA were equitable, important DA variation was apparent among IMGs, with iMRCS pass 21.4% lower and NTN success sixfold less likely than UKG. Targeted counter measures are required to let equity prevail in UK CST programmes.
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“When detected with ultrasound, steal is asymptomatic in 64% of cases.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [422]
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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
New England medical center posterior circulation registry
Caplan, L. R., Wityk, R. J., Glass, T. A., Tapia, J., Pazdera, L., Chang, H., Teal, P. A., Dashe, J. F., Chaves, C. J., Breen, J. C., et al. (2004) · Annals of Neurology · doi:10.1002/ana.20204 · Cited by 507
Wityk, R. J., Chang, H.-M., Rosengart, A. J., Han, W. C., DeWitt, L. D., Pessin, M. S., & Caplan, L. R. (1998) · Archives of Neurology · doi:10.1001/archneur.55.4.470 · Cited by 295
Guía de práctica clínica para el diagnóstico y manejo del síncope (versión 2009)
Moya‐Mitjans, À., Sutton, R., Ammirati, F., Blanc, J., Brignole, M., Dahm, J. B., Deharo, J., Gajek, J. J., Gjesdal, K., Krahn, A. D., et al. (2009) · Revista Española de Cardiología (English Edition) · doi:10.1016/s1885-5857(09)73541-8 · Cited by 277
Metadata
- Authors
- Hennerici, M., Klemm, C., & Rautenberg, W.
- Affiliations
- Heinrich Heine University Düsseldorf (DE)
- Venue
- Neurology
- Published
- 1988-05
- Volume
- 38
- Issue
- 5
- Pages
- 669-669
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2119374834
- Cited by
- 235
- References
- 0
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 13 · 2014: 11 · 2013: 9 · 2012: 6
- FWCI
- 9.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Keywords
- subclavian steal syndrome, vertebral artery, subclavian artery, vertebral artery insufficiency, vertebral artery dissection
- MeSH terms
- Aged, Basilar Artery, Blood Flow Velocity, Brain Ischemia, Ischemic Attack, Transient, Female, Follow-Up Studies, Humans, Male, Nervous System Diseases, Regional Blood Flow, Subclavian Steal Syndrome, Vertebral Artery
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