Synchronous arch arterial occlusion – A clinical impasse?

Peripheral artery disease is considered as an extra-cardiac manifestation of atherosclerosis, and its clinical presentation is equated to lower limb ischemia. A similar pathogenetic mechanism plays a role in luminal stenosis or obliteration of one or more of the aortic arch arteries. This is a presentation of an uncommon case of synchronous athero-thrombotic obliteration of the right brachio-cephalic and left subclavian arteries in a hypertensive male, who had been symptomatic for only 6 hours.