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Figure 1 Subclavian Stenting for Subclavian Steal Syndrome

An 83-year-old woman presented with left arm claudication and dizziness with exertion of her left arm. Asymmetric blood pressure measurements were noted in her upper extremities with systolic blood pressure being 30 mm Hg lower in her left arm. (A) Angiography reveals a high grade ostial left subclavian stenosis (arrow) and reversal of flow in the left vertebral artery. (B) There is severe elastic recoil of the left subclavian artery after balloon angioplasty alone and a balloon expandable 9.0 x 28 mm Omnilink (Guidant, Temecula, California) stent is placed. (C) No residual stenosis remains and antegrade flow in the left vertebral artery is immediately restored. Clinical follow-up demonstrated no recurrence of symptoms at 6 months.