Abstract

Occlusion or stenosis of the proximal portion of the subclavian artery is a common entity and often produces reversal of flow in the ipsilateral vertebral artery. Although most of these patients remain asymptomatic, some of them develop symptoms of vertebral basilar insufficiency. Extrathoracic correction of this syndrome via carotid-subclavian bypass has given excellent clinical results in relieving these patients of symptoms and no evidence of cerebral ischemia has been noted. Surgical correction of this lesion with a side-to-side carotid-subclavian bypass and alternative methods of bypass and their indications are presented