Abstract
Our report on the reversal of blood flow in the left carotid artery in this month's issue of theArchives of Surgery(110:399-401, 1975) is the latest description of a wide variety of physiologic phenomena due to obstructive lesions in major thoracic-cervical arterial branches. Although the clinical case of subclavian steal was recognized and described by Contorni1only in 1960, it is now well known that this and additional phenomena in other parts of the body are not rare. Obstruction in any of the major thoracic aortic arch stems or their branches may result in a clinical syndrome. This phenomenon may occur in any situation in which a hemodynamically significant obstructive lesion is present in a proximal segment of a vessel, resulting in decreased pressure and flow in its distal patent segment. Perfusion of the distal patent segment is then maintained by siphoning off, in a
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