Subclavian steel syndrome and bovine arch

Case contributed by Christof Igler
Diagnosis certain

Presentation

Decreased blood pressure of the left arm. Intermittent dizziness and vertigo. Elevation of the left arm is not possible due to a rotator cuff tear.

Patient Data

Age: 76
Gender: Male

Missing enhancement of the left subclavian artery in the early arterial phase.

Bovine arch.

Proximal subclavian artery stenosis.

Delayed filling of the left vertebral artery and thyreocervical trunc.

Delayed filling of the left subclavian artery.

 

Calcified stenosis of the poximal left subclavian artery.

Bovine arch.

Case Discussion

Subclavian steal syndrome (SSS) results from an occlusion or severe stenosis of the proximal subclavian artery resulting in retrograde flow in the ipsilateral vertebral artery.

Bovine arch is the most common variant of the aortic arch and occurs when the brachiocephalic (innominate) artery shares a common origin with the left common carotid artery

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