Abstract

The functional significance of subclavian artery stenosis is easily gauged by history and physical examination, and I was therefore surprised to see the recommendations in this article for using exercise thallium-201 stress imaging.¹ This is carrying the situation a bit too far. The case report of the lady in this article clearly shows that she had left arm claudication related to her subclavian lesion. The article even goes on to state that with the use of an ergometer for exercise for nearly 3 minutes, the patient had left arm pain. The injection of thallium to confirm the findings, in my view, was expensive and unnecessary. She had an excellent result from left subclavian angioplasty with, as the article states, complete resolution of her symptoms. Therefore, a second follow-up thallium image was again expensive and unnecessary.