From an experience with 16 patients exhibiting a symptomatic subclavian steal syndrome, the following conclusions were reached:
1. Prompt and lasting relief from transient ischemic episodes can be provided by operative intervention.
2. When the right subclavian artery is involved, endarterectomy through a cervical approach is the procedure of choice.
3. Involvement of the left subclavian artery is best handled by employing a carotid-subclavian bypass or ligating the left vertebral artery.
4. Vertebral ligation on either side is particularly effective in the poor-risk patient in whom it can be performed under local anesthesia.
5. Concurrent significant stenosis of an internal carotid artery should be repaired at the time of correction of the subclavian steal, with the latter procedure performed after the carotid endarterectomy.
- © 1970 American Heart Association, Inc.