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Variant of subclavian steal syndrome: unusual anatomical relationship between left subclavian artery and left vertebral artery
  1. Mia McCluskey1,
  2. Peter Baber2,
  3. Shahmir Rind1 and
  4. Dan Xu1,3
  1. 1Curtin Medical School, Curtin University Bentley Campus, Perth, Western Australia, Australia
  2. 2Radiology Department, SKG Radiology, Murdoch, Western Australia, Australia
  3. 3Medical Education & General Practice, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
  1. Correspondence to Professor Dan Xu; daniel.xu{at}


A woman in her 70s presented to her general practitioner (GP) with a 3-month history of left upper arm pain and weakness. A significant difference in bilateral blood pressures was noted and a further history elicited coolness in her left arm without functional compromise. A CT angiography revealed variant subclavian steal syndrome with a subclavian arterial stenosis, which was proximal to both the internal mammary and thyrocervical trunk and her left vertebral artery originating from the aortic arch. She was referred to a vascular surgeon but declined surgical intervention. Her symptoms remain stable with 6-month follow-up from her GP. This case highlights the importance of considering vascular aetiologies in upper limb pain and weakness. Our case reviews the differential diagnoses of upper limb pain and weakness, consequently leading to the discussion of an interesting variant of subclavian stenosis.

  • Cardiovascular medicine
  • Vascular surgery
  • Primary Care
  • Medical education

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  • Contributors MM, being the first author, drafted the initial manuscript, reviewed and edited the final manuscript. SR, being the second author, edited the initial manuscript and figures, reviewed and edited the final manuscript. PB, being the second author, drafted the figures initially, reviewed and edited the final manuscript. DX, being the corresponding author, designed the initial manuscript, reviewed and edited the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.