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June 1964

Cerebral Ischemia: Caused by Occlusive Lesions of the Subclavian or Innominate Arteries

Author Affiliations

From the neurology, radiology, and surgical divisions of Duke University Medical Center and the Durham Veterans Administration Hospital.

Arch Neurol. 1964;10(6):581-589. doi:10.1001/archneur.1964.00460180047004

The current interest in the surgical management of extracranial cerebral vascular disease is largely concerned with occlusive lesions of the cervical portion of the carotid arteries. It is becoming apparent, however, that occlusion of the innominate and subclavian arteries may also produce signs and symptoms of cerebral vascular insufficiency and that surgical removal of obstructions in these vessels may be an effective form of treatment.1-3 It is the purpose of this report to present the clinical manifestations and the radiologic and surgical aspects of this form of cerebral vascular disease. In addition, the factors influencing the development of retrograde circulation in the vertebral arteries associated with subclavian or innominate stenosis, the so-called subclavian steal,4,5 will be reviewed.

Case Material and Roentgenographic Findings  Fourteen patients were studied. All had cerebral ischemia associated with atherosclerotic disease of the subclavian or innominate arteries alone or in combination with other extracranial or

Degree stenosis based on measurement of diameter of vessel in arteriogram. Sm indicates small, ie, 3 mm or less in diameter; ND, no data.
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