Subclavian steal and rest pain in a case of brachiocephalic artery occlusion

Suraj Kapa, Jonathon Adams

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


A patient with multiple vessel disease presented with symptoms of significant bilateral upper extremity pain and weakness that was more significant on the right side. On carotid duplex scanning, brachio- cephalic artery occlusion with retrograde flow was noted through the right common carotid and right vertebral arteries at rest. Furthermore, 50% to 90% occlusion of the left internal carotid was noted. Filling of the right subclavian artery was noted to be through the right vertebral and right common carotid arteries. Unlike isolated subclavian steal syndrome, brachiocephalic artery occlusion induces significant hemodynamic alterations in extracranial arterial flow, which normally produces no symptoms at rest, but may produce symptoms with exercise. The occurrence of subclavian steal phenomenon in the presence of brachiocephalic occlusion is extremely rare. The present case is the first to report a patient presenting with bilateral upper extremity rest pain in the presence of brachiocephalic artery occlusive disease.

Original languageEnglish (US)
Pages (from-to)166-167
Number of pages2
JournalInternational Journal of Angiology
Issue number3
StatePublished - Sep 2008


  • Arm pain
  • Carotid ultrasound
  • Subclavian steal

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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