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September 26, 1966


JAMA. 1966;197(13):1096-1097. doi:10.1001/jama.1966.03110130096028

Blood shunting was not unknown before Reivich et al,1 in 1961, described the reversal of flow through the vertebral artery. Circulatory shunts through various intracardiac arteriovenous or interarterial communications were well recognized. It is just that they never were thought of in the context of a "steal" syndrome. With the "subclavian steal," however, there came awareness of larceny within and suspicion that arteries other than the vertebral may also be victims of theft.

Kountz et al2 report an "aortoiliac steal" syndrome in a patient with arteriosclerotic narrowing of the mesenteric artery who died of intestinal ischemia with gut necrosis following sequential lumbar sympathectomy and iliofemoral bypass for the relief of bilateral common iliac artery occlusion. They postulate that the increased flow to the iliofemoral system, which resulted from these operations, caused the shifting of blood to the legs from an already compromised mesenteric circulation. To further clarify the