Missed Diagnosis of Focal Subclavian Artery Stenosis Discovered During Duplex Ultrasound Examination

Adisyn Gilbert; Shreya Rawat; Ali Hakimi; Tarik Ali

doi:10.1177/15443167261421231

Missed Diagnosis of Focal Subclavian Artery Stenosis Discovered During Duplex Ultrasound Examination

Adisyn Gilbert
, Shreya Rawat
, Ali Hakimi
, Tarik Ali

Department of Surgery

Research output: Contribution to journal › Article › peer-review

Abstract

A 54-year-old woman with fibromuscular dysplasia presented with pain and discoloration of multiple fingers in her left upper extremity due to undiagnosed subclavian artery stenosis, which was presumed to be the source of distal embolization to the ulnar artery. After index computed tomographic angiography (CTA) and follow-up outpatient angiogram results were inconclusive, an arterial duplex examination was performed. A focal flow velocity increase and changes in arterial pulse Doppler waveforms identified a more proximal arterial stenosis that was missed on CTA and digital subtraction angiography.

Original language	English (US)
Pages (from-to)	34-38
Number of pages	5
Journal	Journal for Vascular Ultrasound
Volume	50
Issue number	1
DOIs	https://doi.org/10.1177/15443167261421231
State	Published - Mar 2026

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1177/15443167261421231

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title = "Missed Diagnosis of Focal Subclavian Artery Stenosis Discovered During Duplex Ultrasound Examination",

abstract = "A 54-year-old woman with fibromuscular dysplasia presented with pain and discoloration of multiple fingers in her left upper extremity due to undiagnosed subclavian artery stenosis, which was presumed to be the source of distal embolization to the ulnar artery. After index computed tomographic angiography (CTA) and follow-up outpatient angiogram results were inconclusive, an arterial duplex examination was performed. A focal flow velocity increase and changes in arterial pulse Doppler waveforms identified a more proximal arterial stenosis that was missed on CTA and digital subtraction angiography.",

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AU - Hakimi, Ali

AU - Ali, Tarik

N1 - Publisher Copyright: Â© 2026, Society for Vascular Ultrasound. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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N2 - A 54-year-old woman with fibromuscular dysplasia presented with pain and discoloration of multiple fingers in her left upper extremity due to undiagnosed subclavian artery stenosis, which was presumed to be the source of distal embolization to the ulnar artery. After index computed tomographic angiography (CTA) and follow-up outpatient angiogram results were inconclusive, an arterial duplex examination was performed. A focal flow velocity increase and changes in arterial pulse Doppler waveforms identified a more proximal arterial stenosis that was missed on CTA and digital subtraction angiography.

AB - A 54-year-old woman with fibromuscular dysplasia presented with pain and discoloration of multiple fingers in her left upper extremity due to undiagnosed subclavian artery stenosis, which was presumed to be the source of distal embolization to the ulnar artery. After index computed tomographic angiography (CTA) and follow-up outpatient angiogram results were inconclusive, an arterial duplex examination was performed. A focal flow velocity increase and changes in arterial pulse Doppler waveforms identified a more proximal arterial stenosis that was missed on CTA and digital subtraction angiography.

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Missed Diagnosis of Focal Subclavian Artery Stenosis Discovered During Duplex Ultrasound Examination

Abstract

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