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Right subclavian steal w/steno-occlusive disease of innominate artery (2a)

Right subclavian steal with steno-occlusive disease of the innominate artery (pattern 2). Simplified schematic of the aortic arch and great vessels showing another possible collateral pathway to supply the right arm in the face of severe steno-occlusive disease of the innominate (brachiocephalic) artery (light green box). Flow is reversed in the right vertebral artery, and consequently blood is “stolen” from the vertebrobasilar circulation. In this case, flow is also reversed in the common carotid artery and, so, is stolen from the ipsilateral carotid circulation. (Contributed and modified by Dr. Douglas Lanska. Greatly modified from original sketch in Owen E. A Manual of Anatomy for Senior Students. London and New York: Longmans, Green, and Co., 1890.)