Occluded proximal subclavian artery

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Left arm pain and claudications.

Patient Data

Age: 50 years
Gender: Male

Patent aortic arch showing diffuse atherosclerotic changes. No arch dissection or aneurysmal dilatation.

Occluded proximal segment of the left subclavian artery measuring 2.5cm length. Collateral refilling of its distal segment. Patent its branches (namely patent left vertebral, left internal mammary, thyrocervical trunk and dorsal scapular arteries).

Patent axillary and brachial arteries with no stenotic or occlusive lesions.

Patent common interossous, anterior and posterior inter-osseous arteries which could be traced down to the wrist.

Patent radial artery which could be traced down to the wrist with patent deep palmar arch and palmar metacarpal digital arteries.

Patent ulnar artery which could be traced to the wrist with patent superficial palmar arch and common palmar digital arteries.

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