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Intermittent bilateral subclavian steal detected by ultrasound angiography.

Reverse flow in a vertebral artery secondary to proximal subclavian artery occlusion was described first in an angiographic study (Contorni, 1960). Evolving ultrasonic Doppler techniques now allow non-invasive semiquantitative measurement of velocity and direction of blood flow in these arteries. The diagnosis by a pulsed Doppler imaging system (MAVIS—GEC Medical Ltd.) of the previously unreported condition of bilateral early or intermittent subclavian steal syndrome in a nine-year-old child with Takayasu's arteritis is described. This case emphasizes the potential of such equipment in the investigation and management of arterial disease. A nine-year-old girl from Yugoslavia, whose case was reported in detail after her presentation in this country in 1978 (Rosser, 1979), returned one year later for follow-up. She arrived with a two-week history of vertigo, preceded five months earlier by the loss of the pulses in the right arm. On examination both carotid pulses were prominent, but the right arm pulses we...