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February 1966

True and False Subclavian Steal Syndromes: Collateral Circulation of the True Subclavian Steal Syndrome Demonstrated by Angiography

Author Affiliations

From the surgical (neurosurgery section) and radiological services, Veterans Administration Hospital, Long Beach, and the Department of Anatomy, University of California School of Medicine, Los Angeles.

Arch Surg. 1966;92(2):258-265. doi:10.1001/archsurg.1966.01320200098015

THE SUBCLAVIAN steal syndrome is a well established radiologic entity. The syndrome consists of occlusion or stenosis of a subclavian artery creating a siphoning effect with blood flowing from the opposite vertebral artery through the basilar artery into the vertebral artery of the occluded side.1,2

In the subclavian steal syndrome the main avenue of collateral circulation is the vertebral-vertebral system. Although not always demonstrated angiographically, other collaterals have been mentioned in the literature.3

The increasing use of special diagnostic techniques have made it possible to recognize new cases of subclavian steal syndrome. However, certain technical angiographic aberrations may also produce a reversal of blood flow through the vertebral-vertebral system in the absence of subclavian artery obstruction. We have had the opportunity to observe several such cases and have named them false subclavian steals.

This report presents the roentgenographic features of two cases of true subclavian steal, with emphasis

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