The subclavian artery supplies the blood to neck, thorax, shoulder, head and arms. Due to the narrowing or occlusion of the subclavian artery, there is reverse blood flow in the vertebral artery. This reversal of blood flow is known as subclavian steal syndrome. The symptoms of subclavian steal syndrome are dizziness, vertigo, syncope, and stroke.

The author of the study wrote, “In this study, we reported 23 cases treated in our center to evaluate the safety and effectiveness of endovascular treatment for patients with CTO in the subclavian artery.”

The study includes 23 patients that underwent endovascular treatment for chronic total occlusion of the subclavian artery from January 2010 to May 2017. The doctors diagnosed the lesions with the help of duplex scanning or computed tomography angiography before treatment. Vertebrobasilar insufficiency was found in 16 patients while arm ischemia was present in 6 patients. 2 patients were asymptomatic. 16 patients were found to have grade 3 while 7 patients had grade 2 steal blood flow as revealed by Duplex scanning. Stenting was done to treat lesions after recanalization. After the endovascular treatment, patients were initially followed up at 1, 3, 6, and 12 months and annually thereafter.

The technical success rate was 91.3% while the successful recanalization rate of retrograde and antegrade approaches was 75.0% and 68.2% respectively. The remission rate of symptoms after endovascular treatment was 95.2%. There was no perioperative death or any neurological deficits observed. 


Niu G, Yan Z, Zhang B, Yang M. Endovascular Treatment of Chronic Total Occlusion in the Subclavian Artery: A Review of 23 Cases. Front Neurol. 2020 Apr 24;11:264. doi: 10.3389/fneur.2020.00264. PMID: 32390926; PMCID: PMC7193770.