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Sept 22, 1969

Vascular Thievery

JAMA. 1969;209(12):1899. doi:10.1001/jama.1969.03160250055014

Vascular dishonesty, as evidenced by "false" aneurysms, has been known for a long time. But outright thievery was not recognized until Reivich and his co-workers1 described the theft of blood in the vertebral-basilar system—the "Subclavian Steal." The theft is effected through siphoning of blood from the opposite vertebral-basilar system to a vertebral artery deprived of its due share by a proximal subclavian obstruction. The ensuing reversal of blood flow may then cause transient or permanent symptoms of cerebral ischemia in the contralateral hemisphere despite an intact arterial tree. When both carotid arteries are obstructed, a "Bilateral Subclavian Steal" may result,2 with bizarre symptoms of ischemia in either one of the cerebral hemispheres.

Recognition of the subclavian steal brought with it the suspicion that arteries other than the vertebral may also be victims of the theft. Kountz et al3 reported an "Aortoiliac Steal" syndrome in a patient with