Methods: Subclavian-subclavian arterial bypass was performed in 6 patients (5 men, 1 woman; mean age 61±0.21 years; range 55 to 69 years) with subclavian steal syndrome, between March 2001 and May 2005. Five cases presented with syncope, left upper extremity claudication and exercise-induced vertigo and one patient with angina and left upper extremity claudication. This patient had had internal thoracic artery to left anterior descending artery bypass operation 5 years ago. Physical examination revealed significant difference between the two upper extremity brachial systolic blood pressures. In all cases, aortic arch aortography demonstrated a diffuse segmental occlusion in the proximal subclavian artery. Color Doppler ultrasonography demonstrated retrograde flow in the left vertebral artery. All patients were treated surgically. Subclavian-subclavian bypass was performed in all cases with 8 mm polytetraflouroethylene graft.

Results: No perioperative or postoperative death was observed. Postoperative symptomatic improvement parallelled the abolishment of brachial systolic arterial blood pressure changes. No complications were observed in the postoperative period.

Conclusion: We believe that subclavian-subclavian arterial bypass is a good technique in patients with subclavian steal syndrome and not eligible for angioplasty.