Atherosclerosis of Subclavian Artery vessels can lead to flow-limiting stenosis or distal embolization, which can result in upper extremity ischemia, and vertebrobasilar insufficiency.

Pain and fatigue in upper limbs from repeated use of the upper extremity can be a sign of subclavian or brachiocephalic artery narrowing or stenosis. In more severe cases, rest pain may be present, eventually leading to digital gangrene. In addition, stenotic and/or ulcerative lesions within lumen of Subclavian artery can be a source of microembolic(clots) phenomena to hand.

The clinical consequences of Blocks or Narrowing in Subclavian artery are usually related to the distal embolisms causing arm claudication, pain at rest, and digital ulcerations.

Single-artery occlusion involving the origin of the subclavian artery can cause subclavian-vertebral steal and lead to vertebrobasilar insufficiency. This syndrome is often accompanied by vertigo, nausea, vomiting, imbalance, and diplopia. In patients who have previously undergone coronary artery bypass with the internal mammary artery, angina may recur because of flow reversal in the bypass, which can lead to myocardial ischemia (subclavian-coronary steal) which is an indication for Surgery.

Noninvasive imaging modalities, such as magnetic resonance imaging (MRI) and computed tomography (CT) scan, provide excellent imaging of the aorta and great vessels. But the “gold standard” imaging modality is Angiography.

Upper extremity pain with exertion and/or digital ischemia is a common indication for intervention.

OPTIONS FOR ENDOVASCULAR THERAPY are Angioplasty, primary stenting with use of Embolic Protection devices, when the lesion approaches the origin of the vertebral artery.

Options for open surgical  Revascularization are Anatomical Bypass Grafts and Extraanatomic cervical revascularization.