Vertebral arterial flow reversal in proximal subclavian artery occlusion

Case contributed by Roberto Schubert
Diagnosis certain

Presentation

Recurrent drop attacks, dizziness and blood pressure difference between right and left arm.

Patient Data

Age: 65 years
Gender: Female

No (antegrade) flow signal in the left VA on 3D TOF images. CE-MRA shows that the left arm is supplied by a collateral circulation, that involves retrograde perfusion of the left vertebral artery.

Case Discussion

The left VA flow signal on the 3D multislab TOF images is absent due to ramped flip angles and superior sat pulse.

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