• A Pasco, X Papon, D Fournier, P Mercier, C Caron-Poitreau, and B Enon.
• Department of Radiology, Larrey Hospital, University of Angers, France.
• J Cardiovasc Surg. 1999 Apr 1; 40 (2): 265-9.

AbstractA 48-year-old woman presented with a symptomatic right subclavian steal syndrome due to proximal subclavian artery stenosis. Anatomically the innominate artery was absent. Collateral circulation followed the vertebro-vertebral pathway with reversal of blood flow in the ipsilateral vertebral artery. There was also multiple dilated intervertebral collaterals and an associated saccular aneurysm on one of them. Surgical carotid-subclavian transposition permitted relief of clinical symptoms, disappearance of collateral circulation and subtotal regression of the aneurysm. This spontaneous evolution confirmed the role of high-flow in the pathogenesis of some aneurysms and the habitually good prognosis of flow-related aneurysms with correction of the cause. Arteriography still appears essential in diagnosis, pretherapeutic assessment and sometimes post-treatment evaluation in subclavian steal syndrome.

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