Journal of Vascular Medicine & Surgery

Abstract

Double Steal Syndrome: Two Case Presentations

Ashley D Willoughby, Dwight C Kellicut, Brian H Ching DO, Anthony Katras, Michelle Shimabukuro and Farhan S Ayubi

Double steal syndrome is a phenomenon that has been minimally described in the literature and here we present two cases. The first case presented with symptoms and early evidence of reversal of flow on carotid duplex in the right proximal internal carotid artery with significant innominate stenosis. The second case was an asymptomatic patient with clear retrograde flow observed in the right proximal internal carotid artery with innominate stenosis. Both patients were also found to have reversal of flow in the vertebral artery of the ipsilateral side. Intervention consisted of stent placement at the proximal origin of the innominate artery. Both patients remained on clopidogrel according to post-procedure instructionsand returned to the clinic within the first week for follow up carotid duplex demonstrating decreased innominate velocity with antegrade right internal carotid and vertebral artery flow.