Reversal of Blood Flow in the Right Vertebral Artery Accompanying Occlusion of the Innominate Artery

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Abstract
A patient with severe arteriosclerotic disease and without pulses on the right side of his body was admitted to the hospital with the complaint of intermittent claudication. He had occlusion of the innominate artery, episodes of transient blindness and ataxia unrelated to head position or exercise. Retrograde flow of blood in the right vertebral artery, which contributed to the collateral circulation in the right carotid and subclavian arteries, was demonstrated by arteriograms and direct measurement at the time of operation. This study describes the presence of an "innominate artery steal" similar to the "subclavian steal" described in patients with occlusion of the subclavian artery proximal to the vertebral artery. Insertion of the Teflon prosthesis between the aortic arch and the distal innominate artery restored the blood flow and relieved the symptoms.