Extra-anatomical approach to the congenital subclavian steal syndrome

A young female with cerebral and left arm symptoms from the congenital subclavian steal syndrome is presented. Surgical correction was performed using an axillary-axillary bypass. Pre-operative noninvasive vascular evaluation demonstrated reversal of flow in the left carotid artery which was corrected postoperatively. There was complete relief of symptoms and equal upper extremity blood pressure. This report represents the first instance in which this extremely rare congenital disorder was fully evaluated with noninvasive vascular techniques, and the first to be treated with an extra-anatomical surgical approach.