[Skip to Content]
[Skip to Content Landing]
Article
June 1964

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

Author Affiliations

DURHAM, NC
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
Abstract

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

References
1.
Degree stenosis based on measurement of diameter of vessel in arteriogram. Sm indicates small, ie, 3 mm or less in diameter; ND, no data.
2.
Irvine, W. T., et al:  Intrathoracic Occlusion of Great Vessels Causing Cerebrovascular Insufficiency ,  Lancet 1:1177 ( (June 1) ) 1963.Crossref
3.
Cohen, A., et al:  Occlusive Lesions of Great Vessels of Aortic Arch ,  Arch Surg 84:628 ( (June) ) 1962.Crossref
4.
Williams, C. L.; Scott, S. M.; and Takaro, T.:  Subclavian Steal ,  Circulation 28:14 ( (July) ) 1963.Crossref
5.
Reivich, M., et al:  Reversal of Blood Flow Through Vertebral Artery and Its Effect on Cerebral Circulation ,  New Eng J Med 265:878 ( (Nov 2) ) 1961.Crossref
6.
Ashby, R. N.; Karras, B. G.; and Cannon, A. H.:  Clinical and Roentgenographic Aspects of Subclavian Steal Syndrome ,  Amer J Roentgen 90:535 ( (Sept) ) 1963.
7.
Scott, M., et al:  Vertebral Basilar and Carotid Angiography by Injection of Brachial Artery: Cannula (Noncatheter) Technique ,  Amer J Roentgen 90:546 ( (Sept) ) 1963.
8.
Marshall, T. R.; Ling, J. T.; and Gonzalez, R.:  Additional Experiences With Direct Percutaneous Noncatheter Brachial Angiography—Left Panarteriography—Right Cerebral Angiography ,  Radiology 81:568 ( (Oct) ) 1963.Crossref
9.
Westcott, J. L.; Chynn, K. Y.; and Steinberg, I.:  Percutaneous Transfemoral Selective Arteriography of Brachiocephalic Vessels ,  Amer J Roentgen 90:554 ( (Sept) ) 1963.
10.
Whalen, R. E.; Heyman, A.; and McIntosh, H. D.:  Selective Cinefluorography of Extracranial Cerebral Circulation ,  Circulation 28( (1) ):503 (Oct) 1963.Crossref
11.
Cronquist, S.:  Vertebral Catheterization Via Femoral Artery ,  Acta Radiol (Stockholm) 55:113 ( (Feb) ) 1961.Crossref
12.
North, R. E., et al:  Brachial-Basilar Insufficiency Syndrome ,  Neurology 12:810 ( (Nov) ) 1962.Crossref
×