Subclavian steal syndrome secondary to subclavian artery thrombosis in a patient with homocysteinemia and its successful treatment

Subclavian steal syndrome (SSS) is a rare condition. It results from subclavian artery (SA) stenosis proximal to the origin of the vertebral artery. It is characterized by cerebral ischaemia with associated symptoms of vertebrobasilar hypoperfusion and/or symptoms of brainstem or arm ischaemia. We describe a case of a 35 year old male who presented with persistent vertigo for two months, blue discoloration and pain in the left fingers for two weeks. A diagnosis of SSS was made and patient was treated with a gortex graft from the arch of the aorta to the second portion of the left subclavian artery. Treatment is aimed at restoring permanent antegrade blood flow to the affected vertebral artery. This abolishes vertebral basilar symptoms and other manifestations of SSS. Several modalities exist, however surgical correction is the treatment of choice.