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June 1967

Congenital Atresia of the Subclavian Artery: Producing the "Subclavian Steal Syndrome"

Author Affiliations

From the Department of Pediatrics, Johns Hopkins University School of Medicine and the Cardiac Clinic of the Children's Medical and Surgical Center, Johns Hopkins Hospital, Baltimore.

Am J Dis Child. 1967;113(6):709-713. doi:10.1001/archpedi.1967.02090210123014

THE TERM "subclavian steal syndrome" was first suggested in 19611 to describe the hemodynamic changes and symptoms which occur when there is an occlusion of the intrathoracic portion of the subclavian artery. In this situation blood may reach the affected extremity from a variety of collateral vessels2 depending on the exact site of the occlusion or stenosis in the subclavian artery. The most common condition is occlusion of the left subclavian artery just proximal to the vertebral branch, and the term "subclavian steal syndrome" has been applied to the condition in which there is retrograde flow in the ipsilateral vertebral artery which "steals" blood from the basilar system and sometimes from the circle of Willis, resulting in symptoms of cerebral ischemia. All degrees of shunting of blood have been described from "petty theft" to "grand larceny." Most of the cases have occurred in adults with atherosclerotic occlusion of

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