The "Subclavian Steal" Syndrome: A Further Documentation

The newly characterized "subclavian steal" syndrome represents a unique complication of cerebral arterial occlusive disease. In this condition, obstruction of the proximal subclavian artery can be shown by arteriography to cause an actual egress of blood from the basilar arterial system through a reversal of flow in the ipsilateral vertebral artery. The authors have recently encountered 2 cases of the subclavian steal with cerebral symptoms. One of these patients is believed to be the first documented case of right-sided subclavian steal. Both patients were treated by endarterectomy which appears to be the therapy of choice. Experience with these patients suggests: (1) that the subclavian steal syndrome may be more common than the previous medical literature would indicaten and (2) that this disorder may fail to produce symptoms of cerebral ischemia in the absence of other cerebral vascular disease.