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Unusual Case Report of Subclavian Steal Syndrome Caused by Rare Congenital Vascular Anomaly - Left Subclavian Artery Agenesis with Auto Bypass

Abstract:
The typical branching pattern of the aortic arch is present in approximately 65% of the population. Aortic arch anomalies occur in 35 % of people. Aortic arch and subclavian artery anomalies might occur during embryogenesis, when some parts of the primitive aorta persist or are not formed from the very beginning. In some cases, the causative factor remains unknown, malformation itself is an incidental finding and patients show no symptoms. A few anatomical variants of the aortic arch and the subclavian artery have been described but vascular agenesis seems to be an exceptional finding as it has been reported in only few references, which report cases of unilateral or bilateral congenital absence of the internal carotid artery, vertebral artery agenesis or right subclavian artery agenesis. In this article, the authors present a case of a 51-year-old patient with the subclavian steal syndrome caused by left subclavian artery agenesis, who suffered from undefined arm discomfort and occasional syncope.