Subclavian Steal in Patients with Blalock-Taussig Anastomosis

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Abstract
The reversal of flow in the vertebral-basilar arterial system which occurs following obstruction of the proximal portion of either subclavian artery and its symptomatology has been termed the subclavian steal syndrome. Review of 114 consecutive selective angiocardiograms performed for the purpose of cardiac diagnosis in patients treated with subclavian artery to pulmonary artery anastomosis revealed 12 to show retrograde opacifi-cation of the distal subclavian artery from the vertebral artery on the side of the anastomotic procedure (subclavian steal). Of this group 7 patients had symptoms commonly associated with basilar artery insufficiency. A 2nd group of 8 patients who could be identified angio-graphically as not having a subclavian steal were compared. Although similar in all respects, in only one of these cases were there findings suggesting basilar insufficiency. It is concluded that the subclavian steal, in addition, to the chronic hypoxic state in such patients is responsible for these symptoms.