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March 1964

Subclavian Steal Syndrome

Author Affiliations

Assistant Resident, Department of Surgery, St. Vincent's Hospital (Dr. Gorman); FACS, FACA (Dr. Navarre); Diplomate, American Board of Surgery, Diplomate American Board of Thoracic Surgery, FACS (Dr. McLean).

Arch Surg. 1964;88(3):350-353. doi:10.1001/archsurg.1964.01310210024003

Atherosclerotic occlusive lesions involving the great vessels of the aortic arch, to be distinguished from the poorly defined panarteritis (polyarteritis) as described by Takayusu1 in 1908, have been amenable to surgical correction for the past decade. Because of their usual segmental nature and convenient extracranial locations, thromboendarterectomy and reconstructive procedures have provided satisfactory results in the majority of instances.2,3

Recently it has been shown that a cerebrovascular deficit (in reality a functional basilar artery insufficiency) can exist with isolated atherosclerotic obliteration of the subclavian artery. This paradox of priority has been aptly termed the "subclavian steal" syndrome.4,5

To date, five detailed cases have been described in the literature.4,6,7 It is the purpose of this paper to report an additional two; to our knowledge the first attributed to isolated embolization of the subclavian artery.

Report of Cases 

Case 1.  —A 48-year-old ex-banjo-player and carpenter was admitted April