Subclavian steal syndrome

Case contributed by Paresh K Desai
Diagnosis almost certain

Presentation

Patient with subarachnoid hemorrhage - cerebral angiography was performed.

dsa

On right vertebral injection, the left vertebral was visualized filling the left subclavian. Aortogram shows a stump of occluded left subclavian and delayed filling of the left subclavian which is seen to fill from left vertebral artery.

Case Discussion

Subclavian steal phenomenon occurs when there is a high-grade stenosis at the first part of the subclavian artery, with reversal of flow in the ipsilateral vertebral artery. It usually manifests with posterior circulation symptoms.

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