Carotid Bifurcation Stenosis and Ipsilateral Subclavian Steal

The literature contains numerous reports pertaining to the surgical treatment of either carotid stenosis or proximal subclavian occlusion with reversal of flow through the corresponding vertebral artery.¹⁻⁶When these two lesions occur simultaneously and on the same side, reconstructive surgery may be directed to one of the two arteries, or, as has been our preference in 15 instances, it can be applied to correct both obstructions at the same time. The review of the records of these 15 patients and a description of a surgical technique, with certain modifications to fit anatomical variations, form the basis for this report. Clinical Observations Of the 15 patients under consideration, eight were men and seven were women. Their ages ranged from 39 to 64 years with a mean age of 54 years. All patients were symptomatic. Eight exhibited symptoms of both cerebrovascular insufficiency and arterial insufficiency in the involved extremity. Of the