Among the earliest descriptions of occlusive disease at or near the origin of the major branches of the aortic arch were those by Savory in 185618 and by Broadbent in 1875.2 The various terms subsequently applied to this condition have included, "pulseless disease," "reversed coarctation," "aortic arch syndrome," "young female arteritis," and "chronic subclavian obstruction syndrome." Whatever the terminology used, all cases have been characterized by a decreased blood supply to the head, neck, and upper extremities, with the resultant signs and symptoms of ischemia of the affected parts.
The etiology of this condition remains unknown, although various causative factors, specific and nonspecific, have been considered.17 Pathologic findings in many reports would indicate atherosclerosis3,7,8,14,21; however, others suggest that a nonspecific arteritis is the underlying cause.15 Some of the lack of agreement may arise from the fact that some reports have combined cases of isolated atherosclerotic